image 1Human Resources
Graduate Programs

General:
Adoption Leave Application (PDF 9KB)
Advancement Services Payroll Deduction Form (PDF 357KB)
Bi-Weekly Attendance Sheet (PDF 9KB)
Change of Address Form (PDF 36.2KB)
Conflict of Interest Form (PDF 44KB) Get More Information...
Direct Deposit Form (PDF 12KB) Get More Information...
Domestic Partnership (Non NY Residents) Benefits Application (PDF 6.18KB)
Harassment Online Reporting Form (HTML)
Leave of Absence Form (PDF 8KB) Get More Information...
Monthly Attendance Sheet (PDF 26KB)
Staff Overtime Form (PDF 6KB)
Stop Payment Form (PDF 8KB) Get More Information...
Student Evaluation Form (PDF 37KB)

Fair Credit Reporting Act:
Fair Credit Reporting Act Consumer Disclosure and Authorization (PDF 80KB)
California Resident - Disclosure and Acknowledgement (PDF 58KB)
Summary of Rights(PDF 58KB)

Benefit Forms:
403(b) Salary Reduction Agreement (PDF 80KB)
Dependent Care Account Reimbursement Form (PDF 8KB)
Disability Benefits (PDF 17KB) Get More Information...
Cigna Dental Claim Form (PDF 40KB)
Employee FMLA Rights and Obligations (PDF 12K)Get More Information...
FMLA Health Care CertificationGet More Information...
FMLA Leave Request Form
Get More Information...
Health Care Reimbursement Claim Form (PDF 12KB) Get More Information...
Medco Mail Order Form
Medco Reimbursement Claim Form
Statement of Rights (DB271) (PDF 52KB) Get More Information...
TRIP Claim Form (Parking) (PDF 197KB)
TRIP Claim Form (Transit) (PDF 197KB)
TRIP Enrollment Form (PDF 93.3KB) Get More Information...
UnitedHeatlhcare Claim Form (PDF 47KB)
New Hire Forms:
New Hire Forms (HTML)

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Contact Us
For more information, please contact:

Office of Human Resources
p - 516.877.3220
f - 516.877.4970
e - humanres@adelphi.edu
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