Human Resources  |  Forms

• Benefits •  

• Employment •   

• Leave of Absence •

• New Hire •

• Payroll •  

• Performance Review •

• Records •

• Staff Awards •

• Termination •

• Tuition Remission and Exchange •

University Recognition On Campus (UROC)

 Information

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  Entertainment Books are on sale at a discount to Pacific Employees! order form

Benefits Information

Benefits Overview

• 2009-2010 Benefits Brochure
• 2009-2010 Rate Sheet Tier 1
• 2009-2010 Rate Sheet Tier 2

Benefit Enrollment Forms

• Choices@Pacific Tier 1 Enrollment Election
• Choices@Pacific Tier 2 Enrollment Election
• Medical and Dental and Vision Benefit Enrollment Form for All Plans
• Allegiance Flexible Spending Account Enrollment
• Allegiance Flexible Spending Account-Direct Deposit-Sign up
• Allegiance Flexible Spending Account-Spouse Debit Card Election Form
• Life Insurance Election Form and Beneficiary Designation Form
• Salary Reduction Agreement for Retirement Contributions

Flexible Spending Reimbursement Forms/Plan Information

• Day Care Reimbursement Form
• Medical Expense Reimbursement Form
• Parking Expense Reimbursement Form
• Flexible Spending Account Worksheet

Pacific Pass (Tri-Met) 2008-2009

• 2009-2010 Pacific Pass Enrollment Form

Pioneer Plan Information

• Pioneer Plan Medical Summary
• Pioneer Plan Rx Summary
• Preferred Drug Listing
• Pocket Formulary
• PPS Mail Order Form
• Walgreen's Mail Order Form
• Mental Health and Chemical Dependency Coverage Change
• Pioneer Plan Fee for Service Benefits Summary
• Sample ID Card

• Pioneer Educators Health Trust Plan Document Please NOTE: Alternative Care is NOT available on Pacific University's Plan
• Pacific University Eligibility Summary

Willamette Dental Plan

• Willamette Dental Plan
• Willamette Dental Plan Details

Vision Service Plan

• Vision Service Plan Details
• VSP Participating Doctors/Clinics

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Employment

• Employment Application
• Position Requisition for Faculty & Staff and Instructions
• Position Description Format and Explanation of Physical Requirements
• Employment Procedures for Faculty & Staff
• Personnel Action Form and Instructions
• Funding Plan
• Non-Exempt Pay Grades
• Exempt Pay Grades

Personnel Action Flowcharts

• Flowchart I
• Flowchart II
• Frequently Asked Questions

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Leaves of Absence

• FMLA Medical Documentation
• Leave of Absence Form
• Professional Development Leave

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Forms for New Hires

• Personal Information Form
• I9
• W4
• Direct Deposit Form
• Background Check Authorization
• Confidentiality Agreement
• Moving Expense Letter
• Moving Companies

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Payroll Forms

• Direct Deposit
• Payroll Advance
• Personnel Action Form and Instructions
• Supplemental Pay Request (xls)
• Annual Giving Election
• Non-Exempt Pay Grades
• Exempt Pay Grades
• W4
• Vacation Exception Request

Employee Time Cards

• Non-Exempt Timecard 1st-15th
• Non-Exempt Timecard 16th-End of the Month
• Exempt Timecard

Student Time Cards

• Student Timecard 12 month Workbook
• Student Timecard One Page Worksheet

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Performance Reviews

• Orientation Period Review Form
• Performance Management Review Form
• Manager's Letter 2009
• Peer Customer Input Form
• Supervisory Development Review

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Records

• Address Change Notification Form
• Request to View Personnel File

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Staff Awards

• Nomination Form - Staff Excellence Awards

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Termination

• Notice of Voluntary Resignation
• Request for Final Paycheck

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Tuition Remission and Exchange

• Tuition Remission
• Tuition Exchange Application

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