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Mailing Address
2121 Euclid Avenue
AC 113
Cleveland, OH 44115-2214

Campus Location
Parker Hannifin
Administration Center
2300 Euclid Avenue
Suite 113


Phone: 216.687.3636
Fax: 216.687.9334
hr@csuohio.edu

Forms


Instructions: Select the file and format you want to download  by clicking on the appropriate icon, refer to the following legend for a description of the icons.

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Benefits Forms


Accident/Injury (Workers' Compensation)    
  • Guidelines
Download in MS WORD format Download in Adobe PDF
  • Report for Supervisors
Download in MS WORD format Download in Adobe PDF
  • Report for Employees
Download in Adobe PDF
Domestic Partner    
  • Affidavit of Domestic Partnership
Download in MS WORD format Download in Adobe PDF
  • Affidavit of Termination of Domestic Partnership
Download in MS WORD format Download in Adobe PDF
Family and Medical Leave    
  • Intermittent FMLA Reporting Procedure
Download in MS WORD format Download in Adobe PDF
  • Intermittent Leave Usage Log
Download in MS WORD format Download in Adobe PDF
Flexible Spending    
  • FSA Claim Form
Download in MS WORD format Download in Adobe PDF
  • FSA Direct Deposit Form
Download in MS WORD format Download in Adobe PDF
Health Benefit Choices    
  • Benefit Election (Full Time)
Download in MS WORD format Download in Adobe PDF
  • Benefit Election (Part Time)
Download in MS WORD format Download in Adobe PDF
  • Cash Option Verification Form
Download in MS WORD format Download in Adobe PDF
Life Insurance    

  • Beneficiary Change Form
Download in MS WORD format Download in Adobe PDF
  • Evidence of Insurability Form
    (For Life Insurance above the guaranteed amounts)
  Download in Adobe PDF
  • Waiver Agreement
  Download in Adobe PDF
Medical Mutual    
  • Dental Claim Form
  Download in Adobe PDF
  • MMO Medical Claim Form
  Download in Adobe PDF
  • MMO Rx Claim Form
  Download in Adobe PDF
  • Student Certification Form
  Download in Adobe PDF
Retirement    
  • 403(b) Salary reduction agreement
Download in MS WORD format Download in Adobe PDF
  • Counseling Questionnaire (OPERS)
  Download in Adobe PDF
  • Counseling Questionnaire (STRS)
  Download in Adobe PDF
  • Retirement Plan Election Form
  Download in Adobe PDF
  • Sick Leave Payout Form
Download in MS WORD format Download in Adobe PDF
Tuition Benefits    
  • Fee Authorization (Dependents)
Download in MS WORD format Download in Adobe PDF
  • Staff Development (Faculty/Staff)
Download in MS WORD format Download in Adobe PDF
Vacation Exemption    
  • Vacation Exemption Form
Download in MS WORD format Download in Adobe PDF
 
 

Forms for Classified Staff


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Job Application (please visit Classified Vacancies page for more details)    
Audit Request    Download in MS WORD format Download in Adobe PDF
Evaluation    
  • Annual   
Download in MS WORD format Download in Adobe PDF
  • Probationary   
Download in MS WORD format Download in Adobe PDF
Exit Interview    Download in MS WORD format Download in Adobe PDF
Personnel Request (CPR)    Download in MS WORD format Download in Adobe PDF
Temporary Pay Adjustment (CWA)    Download in MS WORD format Download in Adobe PDF
Temporary Pay Adjustment (Non-Bargaining)  Download in MS WORD format Download in Adobe PDF
 
 

Forms for Professional Staff


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Advertising Request     Download in MS WORD format Download in Adobe PDF
Evaluation    Download in MS WORD format Download in Adobe PDF
Exit Interview     Download in MS WORD format Download in Adobe PDF
Job Description Template    Download in MS WORD format Download in Adobe PDF
Position Description Questionnaire    Download in MS WORD format Download in Adobe PDF

Reclassification Request   

Download in MS WORD format Download in Adobe PDF

Temporary Transfer (SEIU)   

Download in MS WORD format Download in Adobe PDF
Temporary Transfer/Interim Assignment (Non-Bargaining) Download in MS WORD format Download in Adobe PDF
 
 

Contract Preparation and
Guidelines


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Employment Contract (Professional Non-Bargaining)    
  • Interim Assignment/Temporary Transfer (Non-Bargaining)
   
    • Guidelines   
Download in MS WORD format Download in Adobe PDF
    • Form   
Download in MS WORD format Download in Adobe PDF
Letters of Appointment (SEIU)
  • FT Salaried Professional (SEIU)
   
    • Guidelines   
Download in MS WORD format Download in Adobe PDF
    • Form   
Download in MS WORD format Download in Adobe PDF
  • PT Salaried Professional (SEIU)
   
    • Guidelines
Download in MS WORD format Download in Adobe PDF
    • Form
Download in MS WORD format Download in Adobe PDF
  • PT Hourly Professional (SEIU)
   
    • Guidelines  
Download in MS WORD format Download in Adobe PDF
    • Form   
Download in MS WORD format Download in Adobe PDF
  • Temporary Transfer (SEIU)
   
    • Guidelines
Download in MS WORD format Download in Adobe PDF
    • Form
Download in MS WORD format Download in Adobe PDF

Full-Time Faculty
All contracts are to be completed through the the Provost's Office of Fiscal Operations.

   
  • Overload Appointment
   
    • Guidelines   
Download in MS WORD format Download in Adobe PDF
    • Form   
Download in MS WORD format Download in Adobe PDF
  • Summer Contract
   
    • Guidelines
Download in MS WORD format Download in Adobe PDF
    • Form   
Download in MS WORD format Download in Adobe PDF
Part-Time Single Term Special Status Faculty    
  • PT Single Term Instructional Contract
   
    • Guidelines    
Download in MS WORD format Download in Adobe PDF
    • Form   
Download in MS WORD format Download in Adobe PDF
  • PT Single Term Non-Instructional Contract
   
    • Guidelines    
Download in MS WORD format Download in Adobe PDF
    • Form
Download in MS WORD format Download in Adobe PDF
     
Special Payment Form      
    • Guidelines    
Download in MS WORD format Download in Adobe PDF
    • Form
Download in MS WORD format Download in Adobe PDF
     
Reference Material    
  • General HR Paperwork Definitions
  Download in Adobe PDF
  • FTE and STRS Calculation Notes 
  Download in Adobe PDF
  • Credit Hours and FTE Conversion 
  Download in Adobe PDF
  • Department ID and Name
  Download in Adobe PDF
  • Guidelines for Staff Authorization for PT Single Term Contract
  Download in Adobe PDF
  • Single Term Contract Titles
  Download in Adobe PDF
     
 

General HR Forms


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Ohio Ethics Law Acknowledgement Download in MS WORD format Download in Adobe PDF

Personal Data Worksheet (PDW)
(Red BulletNote: The PDW is to be printed as a 2-sided form on canary yellow paper.  Paper may be purchased from CSU's Duplicating Department.)

Download in MS WORD format Download in Adobe PDF

Personnel Action Worksheet (PAW)
(Red BulletNote: The PAW is to be printed as a 2-sided form on light green paper.  Paper may be purchased from CSU's Duplicating Department.)

Download in MS WORD format Download in Adobe PDF
Position Number Request   Download in MS WORD format Download in Adobe PDF
Position Search Approval Download in MS WORD format Download in Adobe PDF
     
 

Substance Abuse Testing Forms


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Managerial Checklists Download in MS WORD format Download in Adobe PDF
Managerial Observation Form Download in MS WORD format Download in Adobe PDF
Referral Form and map to testing location Download in MS WORD format Download in Adobe PDF
 
 

Forms from External Sources


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DMA for Public Employment
(Source: U.S. Department of Homeland Security)
  Download in Adobe PDF
     
I-9, Employment Eligibility Verification
(Source: U.S. Department of Homeland Security)
   
     
SSA Form 1945, Statement Concerning Your Employment in a Job Not Covered by Social Security (Source: U.S. Social Security Administration)    
  • Instructions   
Download in MS WORD format Download in Adobe PDF
  • Form   
  Download in Adobe PDF

 

 

 


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Cleveland State University   •   2121 Euclid Avenue, Cleveland, OH 44115-2214   •   216.687.2000
This page last modified Monday, January 14, 2008