Wichita State University -- Forms
WSU Policies & Procedures Manual
(The University resource of policies and procedures.)
Alphabetical Index of HR Forms
| [A] | [B] | [C] | [D] | [E] | [F] | [G] | [H] | [I] | [J] | [K] | [L] | [M] | [N] | |
| [O] | [P] | [Q] | [R] | [S] | [T] | [U] | [V] | [W] | [X] | [Y] | [Z] |
| Forms by Name | Link to Instructions | Purpose of this Form | Versions |
| AAO - 1/Search Process | Click here to go to search forms for unclassified professionals & faculty. | ||
| Accident or Illness Report Form | Report must be sent to Office of Human Resources within 3 days of Workers Comp related incident. |
Word |
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| Advanced Leave | Leave Advancement is leave provided to an employee pursuant to Executive Order 09-08 (see Bulletin No. 09-05) and must be requested and approved in accordance with appropriate agency policies and procedures. A committee, chaired by the Director of Human Resources, may choose not to provide this leave to an employee if it is believed an employee has abused their leave privileges. | ||
| Additional Compensation, OHR 210 | Compensation for work not related to a full-time unclassified employee'sregular duties and not performed during regular work hours (e.g. teaching a class). | ||
| Address Change | To notify the Office of Human Resources of employee's address change. |
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| Advance Earned Income Credit, W-5 |
Included |
Use Form W-5 if you are eligible to get part of the earned income credit (EIC) in advance with your pay and choose to do so. See the form for "Who Is Eligible To Get Advance EIC Payments?" |
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| Agency Temp, Clerical Request |
Pay Chart |
To hire individuals through a temporary agency as per contract with the State of KS. |
Word |
| Agency Temp, Industrial Technology Request |
Pay Chart |
To hire individuals through a temporary agency as per contract with the State of KS. |
Word |
| Agency Temp, Trades Request |
Pay Chart |
To hire individuals through a temporary agency as per contract with the State of KS. |
Word |
| Americans with Disabilities (ADA) | This form is used for reporting of disability status and request for special accommodations. | ||
| Applicant Screening Criteria for Classified Positions |
Checksheet for filling Classified Position |
This form is used by search committee for Classified staff positions. |
Word |
| Appointment, OHR 300 |
OHR 300 |
To appoint an individual to a position (other than as a Lecturer, Research or Summer Session appointment) at the conclusion of a search or direct hire to a new position. |
Word |
| Appointment - Lecturer, OHR 310 |
OHR 310 |
To appoint temporary semester appointments that may include lecturers and paid adjunct appointments. Exempt positions paid a salary either incrementally or at semester end. (May be benefits eligible, dependent on credit hours taught in consecutive semesters.) |
Word |
| Appointment - Research, OHR 320 |
OHR 320 |
To appoint classified, unclassified professional or faculty to a position that is partially or totally grant funded. |
Word |
| Appointment - Research Summer Session, OHR 323 |
OHR 323 |
Used to appoint a 9 or 10 month academic, who would ordinarily not teach in the summer, to a position at WSU that is partially or totally grant funded, contract funded or research. |
Word |
| Appointment - Summer Session, OHR 330 |
OHR 330 |
Appoint lecturer or other unclassified employee (for other than 12-month)during the summer academic period. |
Word |
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Authorization and Release for Employment Inquiries |
To be signed by applicants to give search committee permission to contact previous employers, etc. | ||
| Background Checks |
Background checks are required for each person hired for a faculty, unclassified or classified positions at WSU that will continue for a term of longer than 6 months. See Protocols and Best Practices for guidelines and forms required. Who Pays? There is a central fund in the Office of Human Resources that will pay for all GU positions through their Business Procurement Card (BPC); RU positions will need to be funded by the hiring unit. OHR will assign the BPC charges for RU positions to the hiring unit. |
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| Change of Effort and Funding - Research, OHR 420 | OHR 420 | Used to show any change in effort and funding of a position or employee that is partially or totally grant funded, contract funded, or research. | |
| Change of Status, OHR 200 |
OHR 200 |
To show any change in a current employee's status (e.g. promotion or transfer within the University, retirement, termination, name change, reclassification, FTE, title change, provisional to regular appointment, funding change, etc.) |
Word |
| Change of Status - Research, OHR 220 |
OHR 220 |
Project Director is to prepare a rough draft and send to Office of Research Administration, Campus Box #7 for completion of the form. |
Word |
| Claims Against the State | Click here for personal injury or property loss guidelines and forms. | ||
| Classified | How to fill a position: Classified Temporary -- State Temporary -- Agency |
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| Classified Employee Evaluation & Development System (CEEDS) |
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An on-line evaluation system for classified support staff. Supervisors should contact Joan.Antes@wichita.edu to schedule training. | |
| Classified Employee Referral Record |
(OHR 114)Included on 2nd page |
Form to be completed by search chair for each applicant scheduled for interview. |
Word |
| Coaching & Behavior Report, Employee | This form to be used by managers to document performance or behavior issues of their employees (formal write-up). Type in the form and print completed form for signatures. Contact Matthew Johnston with questions/concerns. | ||
| Direct Payroll Deposit | Complete this form and submit with voided check or deposit slip for employee's salary to be deposited directly to their bank. |
Word |
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| Disciplinary Action - Sample Memo | Sample format of a memo to employee from supervisor in regard to disciplinary issues. | Word | |
| EEO Applicant Information Form | Statistical information request as part of a professional job search. |
Word |
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| Employee Coaching & Behavior Report | This form to be used by managers to document performance or behavior issues of their employees (formal write-up). Type in the form and print completed form for signatures. Contact Matthew Johnston with questions/concerns. | ||
| Employee Information -- Students | The State of Kansas requires this 2-page form for all student employees to record their personal information and emergency contacts. All sections must be completed. |
Word |
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| Employee Information -- Unclassified Employees | The State of Kansas requires this information for all employees (except student employees) to record personal information and emergency contacts. All sections must be completed. |
Word |
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| Employee Suggestion Form |
Guidelines |
A WSU employee whose suggestion is approved and implemented shall receive a "monetary employee award" and an "employee suggestion bonus" as permitted by law and as outlined in the policy guidelines. |
Word |
| Exception Reporting (faculty included) | Departments with faculty members may use this form for individuals to report exceptions to their schedule for timekeeping purposes. |
Word |
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| Exception Reporting (faculty not included) | Departments with no faculty members may use this form for individuals to report exceptions to their schedule for timekeeping purposes. |
Word |
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| Exit Interview Form | Internal HR form used in the employee exit process -- resignation, retirement, etc. |
Word |
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| Faculty | Checklist for filling a faculty position. | ||
| Flexible Spending Claim Form (ASI) |
Included |
To claim reimbursement of dependent care and unreimbursed medical expenses. |
Word |
| FLSA Designation Form | Q & A's | To comply with the Federal Fair Labor Standards Act (FLSA) and University policy, departments must complete the FLSA Designation Form for all unclassified professional positions and forward with the position description to Office of Human Resources, Campus Box #15. | |
| FMLA Certification of Health Care Provider |
FMLA Guidelines |
For the physician to provide information concerning the patient to determine FMLA eligibility.This also includes the Return to Work Authorization form necessary to return to work after a qualifying event. |
Word |
| FMLA Certification of Qualifying Exigency for Military | To be completed by the employee. | ||
| FMLA Certification for Serious Injury or Illness of Covered Service Member | To be completed by a Department of Defense health care provider. | ||
| FMLA Request Forms | The employee must notify the employer (your immediate Supervisor or the Office of Human Resources FMLA representative) of the need for taking Family and Medical Leave at least 30 days in advance before FMLA leave is to begin, if the need for leave is foreseeable. |
Word |
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| FMLA Timekeeping Verification | Used to track FMLA certified absences for one diagnosis. Use this form to record the hours absent for each FMLA absence as the absence occurs. |
Word |
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| Graduate Teaching/Research Assistant Appointment Proposal/Payroll Authorization, OHR 131 |
Hiring Process |
Appoint a graduate assistant to a new position. Department must obtain appropriate signatures (as per funding) in the order listed; then send original to Graduate School, Campus Box #4, for processing. Department to complete this form and the green pre-employment form (hard copy available in Human Resources) to hire a grad applicant. |
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| Graduate Teaching/Research Assistant Appointment/Payroll Change of Status, OHR 132 |
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Make a change in the current appointment of a graduate assistant. Used when a position is terminated prior to original appointment end. Department must obtain appropriate signatures (as per funding) in the order listed; then send original to Graduate School, Campus Box #4, for processing. |
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| I-9/Employment Eligibility Verification |
Included |
All U.S. employers are responsible for completion and retention of Form I-9 for each individual they hire for employment. This includes citizens and noncitizens. | |
| International Student Employment VerificationLetter |
Included |
Form letter will need to be completed by the hiring department for the nonimmigrant student to present to the Social Security Administration to receive a social security card to work on campus. |
Word |
| K-4 |
Included |
Employees hired after 1/1/08 must use the new Form K-4 for State withholding tax purposes. Employees hired prior to 1/1/08 who wish to adjust state withholding will be required to complete the K-4 form. These options may now differ from the Federal withholding elections made on Form W-4. |
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| Kansas Mentors Program |
About the Program |
Employees may use up to 90 minutes of work time per pay period to work with an approved mentoring program. This time must fall within the employee's regular work schedule and shall not be used during or result in overtime for non-exempt employees. |
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| Leave Advancement | Leave Advancement is leave provided to an employee pursuant to Executive Order 09-08 (see Bulletin No. 09-05) and must be requested and approved in accordance with appropriate agency policies and procedures. A committee, chaired by the Director of Human Resources, may choose not to provide this leave to an employee if it is believed an employee has abused their leave privileges. | ||
| Leave and Overtime Request Form | Optional department timekeeping form |
Word |
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| List Order Form | To order a list for on-campus mailings of current employees or retirees at their home address, you can refer to the Request for Mailing Lists. Electronic media is the property of Wichita State University and should be used for the primary purpose of benefiting, enhancing and furthering the mission of the University. | ||
| New Hire Report, State of Kansas | Required by the State of Kansas to report newly hired, rehired and returning employees. # All new employees must fill out section 1 and answer the questions. # Department fills out section 2. |
Word |
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| Oath/Tax Form | (A Notary Public is available in Human Resources) This form includes the Federal Withholding Form W-4 and the State of Kansas Employee's Oath. # Be sure the employee fills out this form completely, signs and dates. # The signature on the oath portion of the form must be signed in front of a Notary Public. # For questions about allowances, call Payroll at 3074 or Human Resources at 3065. # The K-4 is also required with the W-4. |
Word |
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| Payroll Deposit Form | Complete this form and submit with voided check or deposit slip for employee's salary to be deposited directly to their bank. |
Word |
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| Payroll Schedule | Schedule of pay periods, pay dates and due dates for paperwork: | ||
| Performance Management Process | An evaluation tool to manage performance of classified employees. See August 21, 2008 memo from then Governor, Kathleen Sebelius, in regard to the New Performance Management Process. | ||
| Position Description, Classified | A 4-page form to describe duties and responsibilities for classified positions. If this file doesn't save correctly to your computer, contact Libby.Gilbert@wichita.edu or call (316) 978-6124. |
Word |
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| Position Description, Unclassified | Definitions & Examples | A 2-page form to describe duties and responsibilities for unclassified positions. Assistance and direction for writing position descriptions will be provided by Human Resources. Contact Lana.Anthis@wichita.edu or call (316) 978-6166 or Libby.Gilbert@wichita.edu or call (316) 978-6124. | Word |
| Positive Time Reporting (in-out) | An optional timekeeping form. |
Word |
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| Reclass Request |
Instructions included on 1st page |
Contact Libby Gilbert prior to completing a request to reclassify a position. |
Word |
| Reclassification: Employee Worksheet | A 2-page form that an employee may use to outline the duties & responsibilities of their position when seeking a reclassification. |
Word |
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| Reclassification: Supervisory Analysis of Position | A 2-page form that the supervisor can use to analyze a position that might be considered for reclassification. |
Word |
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| Referral Record, Classified Employee |
Included on 2nd page |
Form to be completed by search chair for each applicant scheduled for interview. |
Word |
| Request to Fill, OHR 100 |
OHR 100 |
Begins the search process to fill any classified, unclassified or faculty position at WSU. |
Word |
| Request to Fill - Research, OHR 120 |
OHR 120 |
Project Director is to prepare a rough draft and send to Office of Research Administration, Campus Box #7 for completion of the form. |
Word |
| Resignation Form Letter | Employee should give supervisor written notice of resignation. |
Word |
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| Return to Work Authorization | Last page of FMLA Certificate of Health Care Provider |
Word |
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| Search Process Report: Step 1 of the AAO - 1 form |
Hiring Process: Unclassified |
Initiation of the search for unclassified professionals & faculty on page 1 and complete list of required/preferred experience, knowledge, skills and abilitities on page 2. |
Word |
| Search Process Report: Step 2 of the AAO - 1 form |
Download applicants to evaluation grid |
Evaluation/Interview Selection. This file consists of three parts: Page down to part 2 to complete the Evaluation Grid; after all applicants have been evaluated, part 1 of step 2 should be completed. Go to the end of the file to complete the Search Plan Exceptions if there are exceptions to the original search plan. |
Word |
| Search Process Report: Step 3 of the AAO - 1 form | Selection Matrix consists of two parts: part 1 is a second evaluation grid only for applicants who are interviewed - ranked in order of preference or as not acceptable. Part 2 is an explanation and/or justification to be completed if someone other than the committee's first choice is recommended or other necessary documentation. |
Word |
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| Selection Matrix for Classified Interview |
Checksheet for filling Classified Position |
Search chair to complete this grid to submit to HR. |
Excel |
| Shared Leave, Confidentiality Waiver | Authorization for WSU to obtain necessary information in regard to your request for shared leave. |
Word |
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| Shared Leave, Donation of Time | Form for WSU employee to voluntarily donate leave to another employee on shared leave. |
Word |
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| Shared Leave, Request for Time |
Guidelines |
Form for WSU employee to apply for shared leave. |
Word |
| Social Security (for jobs not covered) |
SSA-1945 |
All student employees hired after 1/1/2005 must complete this form. |
Word |
| State of KS Employees Oath | Must be signed by new employees before entering the duties for employment and before funds for services may be disbursed. |
Word |
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| Student |
How to fill a position: |
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| Student Change of Status, OHR 134 |
Hard copies not accepted after 10/31/09 |
Make a change in the appointment of a student employee or terminate a student employee from a position. # Insert the department number along with the corresponding position number below so that the correct positions are changed. |
Word |
| Student Consent for Inspection | All student employees required to sign this form to authorize WSU to inspect and/or release form I-9 information to Immigration & Naturalization Service. |
Word |
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| Student Employment Application | Departments may use this application format. |
Word |
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| Student Employment Authorization, OHR 133 | Hard copies not accepted after 10/31/09 | Appoint a regular or work-study student to a new position. |
Word |
| Student Exception Request | Request for exception of minimum credit hours requirement for students to work on campus. |
Word |
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| Substance Abuse Policy | This form is required by state law; the department signs as Agency Representative. |
Word |
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| Tax Clearance Information Form | Form to acknowledge that candidate or employee has been informed of the Tax Clearance Program for the State of Kansas and that they're aware of the requirements for payment, if applicable. | ||
| Tax Compliance, Glacier Nonresident Alien Withholding | Enrollment for a web based tax compliance system for foreign nationals employed by the University. |
Word |
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| Tax Withholding, State K-4 |
Included |
Complete this form to change number of dependents for State income tax withholding from employee's salary. |
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| Tax Withholding, Federal W-4 |
Included |
Complete this form to change number of dependents for income tax withholding from employee's salary. |
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| Temporary Agency Help -- Administrative | Requisition form to request temporary agency administrative & office support staff. | ||
| Temporary Agency Help -- Information Technology | Requisition form to request temporary agency information technology staff. | ||
| Temporary Agency Help -- Trades & Light Industrial | Requisition form to request temporary agency trades & light industrial staff. | ||
| Tuition Assistance Application |
Guidelines |
The University has authority under state law to pay tuition and other education expenses for the education or training of eligible University employees when such education or training has been determined to be of value to the state and the University. |
Word |
| Unclassified | Checklist for filling an unclassified position. | ||
| Voluntary Investment Agreement Plan | This Investment Agreement is entered into between the undersigned employee of the Wichita State University in order for salary deferral contributions to be made to the Kansas Board of Regents Voluntary Retirement Plan under Internal Revenue Code (IRC) Section 403(b) and K.S.A. 74-4925b. |
Word |
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| W-5, Advance Earned Income Credit |
Included |
Use Form W-5 if you are eligible to get part of the earned income credit (EIC) in advance with your pay and choose to do so. See the form for "Who Is Eligible To Get Advance EIC Payments?" |
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| Withholding Tax, State K-4 |
Included |
Complete this form to change number of dependents for State income tax withholding from employee's salary. |
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| Withholding Tax, Federal W-4 | Complete this form to change number of dependents for income tax withholding from employee's salary. | ||
| Workers Compensation Employee Accident or Illness Report | Complete this form within 3 days of any work-related accident or illness. |
Word |
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| Workers Compensation Mileage | Complete this form to report trips in excess of 5 miles in connection with your Workers Comp claim. |
Word |
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