Benefit Forms
Education Benefits Program
- Application for Dependent Child (NWLA, Open Tuition, TE Exchange)
- Tuition Remission Application for Dependent Child (PDF)
- Tuition Remission Application for Faculty/Staff or Spouse/Domestic Partner (PDF)
- Affidavit of marriage or domestic partnership (PDF)
Flexible Benefits Program
- 2021 After-Tax Payroll Authorization Form
- Affidavit of marriage or domestic partnership (PDF)
- Beneficiary Designation Form (PDF) (life insurance and AD&D insurance)
- Authorization for use and/or disclosure of protected health information (DOC)
- Flexible Spending Account (FSA) Claim Form (PDF)
- Critical Illness Claim Form (PDF)
- Group Accident Claim Form (PDF)
Leave of Absence
- Certification of health care provider (PDF) - employee's own health condition
- Certification of health care provider (PDF) - family member's health condition
- Faculty leave request form (PDF)
- Leave of absence request form (PDF)
- Release to return to work form (PDF)
Life & Disability
Employment Forms
- Application for employment
- Department checklist for new staff members (PDF)
- Demographic information form (PDF)
- Interview evaluation form (PDF)
- Moving expense reimbursement form (PDF)
- Reference check form (DOC)
- Ethnic Origins Survey (DOC) and Invitation to Self-Identify (PDF)
General Human Resources Forms
- Complaint resolution form (PDF)
- Written notice of performance improvement (DOC) (formerly Written Corrective Action)
- Name change form (PDF)
- Non-disclosure and confidentiality agreement (DOC)
- Telework Agreement Form (PDF)
- Conflict of Interest Disclosure and Authorization Form (DOC)
- University of Puget Sound organizational chart September 2022 (PDF)
Leaving University Employment
-
Departure form (PDF)
Staff Performance Review and Development
- Staff Performance Review Program (PDF)
- Performance Summary Form (required) (DOC)
- Performance development plan (DOC)
- Performance Management Tools and Resources