Evaluations
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Suggested template for classroom observation developed by the Faculty Affairs Committee
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Academic Employees, Evaluations
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Required for Faculty hired Academic Year 2019/20 and later; required for tenured Associate Professors promoted effective AY 2019/20. Optional for Faculty currently in Probationary period; optional for tenured Associate Professors promoted prior to AY 2019/20.
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The Professional Development Plan (PDP) is a flexible document that reflects the strengths of the candidate and her/his professional development goals.
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For use by Lecturers seeking Range Elevation
Benefits
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Attach supporting documentation and submit to ASIFlex
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Request for Non-Emergency Medical Transportation for Work-Related Injuries
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A Cal-Ore Life Flight membership ensures the patient will have no out-of-pocket flight expenses if flown by the Company or another AirMedCare Network participating provider
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If you are in the process or have already separated from all CalPERS-covered employment, you will need to consider whether you want to keep your retirement contributions on deposit with CalPERS or receive a refund.
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Career Development Plans use an online submission process which provides the opportunity to sign, gain signatures and submit electronically.
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Employee’s Report of Injury (DWC-1) – Must be given to employee at the time injury is reported to Supervisor, or as soon as possible after medical treatment is received
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Predesignation of a Personal Physician
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This booklet contains information and a payment application to help you select the payment method that best meets your needs.
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Supervisor’s Report of Injury – MUST BE SUBMITTED TO HUMAN RESOURCES WITHIN 24 HOURS OF KNOWLEDGE OF INJURY
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Employer Paid Life and AD&D Beneficiary Designation and Change Form
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The VSP Video Display Terminal (VDT) Confirmation Form is only provided to CSU employees who meet the necessary job requirements as determined by the CSU campus benefits office. This form must be completed by the employee and provided to a VSP Select Network doctor to receive the supplemental VDT benefit.
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The document includes links to all the necessary forms for the Workers' Compensation process.
Academic Employees, Benefits
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Available to eligible faculty unit employees only.
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Available to eligible faculty unit employees only.
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Tenured Faculty Unit employees who have reached the age of 55 are eligible to participate in the program.
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Notary Pages for Approved Sabbatical and DIP Leaves
Equal Opportunity and Compliance
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This confidentiality form is to be used by applicants or employees who are requesting an accommodation based on a disability. Applicants and employees requesting services will be subject to qualification standards as defined by federal and state laws relating to disability.
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Employee/applicant shall contact the treating health care provider to complete this form. Employee/ applicant should return the completed form to ADA coordinator at Humboldt State University Human Resources.
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Acknowledgement of Mandated Reporter Status and Legal Duty to Report Child Abuse and Neglect (EO 1083)
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California law requires certain people, known as “Mandated Reporters,” to report known or suspected child abuse or neglect. You have been identified as a certain type of Mandated Reporter: a Limited Reporter under Penal Code § 11165.7(a)(41). As a Mandated Reporter, you are required by the law to sign this statement acknowledging your legal reporting obligations.
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Child Abuse Reporting Form
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To Be Completed by Mandated Child Abuse Reporters Pursuant to Penal Code Section 11166
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This complaint form is for use by individuals who are eligible to file a complaint of Discrimination, Harassment, Retaliation, Sexual Misconduct, Dating or Domestic Violence or Stalking under Executive Order 1096.
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Student Complaint Form
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Form 700 only. No introduction.
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The Political Reform Act (Gov. Code Sections 81000- 91014) requires most state and local government of cials and employees to publicly disclose their personal assets and income. They also must disqualify themselves from participating in decisions that may affect their personal economic interests. The Fair Political Practices Commission (FPPC) is the state agency responsible for issuing the attached Statement of Economic Interests, Form 700, and for interpreting the law’s provisions.
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This form is used to report certain payments received by state and local government agencies. It includes: • a payment for an o cial’s travel expenses for the purpose of facilita ng the public’s business in lieu of a payment using agency funds; and • a payment that would otherwise be considered a gi or income to the bene ng o cial, but is instead accepted on behalf of the agency.
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This complaint form is to be used to file a Protected Disclosure of Improper Governmental Activities and/or Significant Threats to Health or Safety under Executive Order 929.
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The California Whistleblower Protection Act authorizes the California State Auditor to receive complaints from state employees and members of the public who wish to report an improper governmental activity. Note: Complaints are not accepted via email.
Onboarding
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California law requires certain people to report known or suspected child abuse or neglect.
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Apply for an original Social Security card, apply for a replacement Social Security card, change or correct information on your Social Security number record
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The Reciprocal Self-Certification form allows you to provide essential information to your employer and will be used by your employer to enroll you into CalPERS membership.
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The Account Request process is used to add, modify, or delete a person's (user or developer) access to PeopleSoft Human Resources, PeopleSoft Campus Solutions, Customer Relationship Management, PeopleSoft Finance, and/or OBI enterprise applications.
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Humboldt State University Information System Access and Compliance Form for Academic Professionals of California (Unit 4) Employees
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Humboldt State University Confidentiality Statement for Employees, Consultants, and Independent Contractors Accessing University Records - Student Assistants can also use this form.
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Humboldt State University Confidentiality Statement for Faculty Access and Compliance Form
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Important: This is NOT a designation for payment of death benefits and refund of employee retirement contributions.
Onboarding, Recruitment
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Gathers personal info from new hires for PeopleSoft and POI creation