Human Resources Forms

The Forms available below are the most common forms used by our office and by our benefit carriers.  Please reference the appropriate sections of the website for all related forms and documents.

The documents on this page are in Adobe PDF format, therefore you will need a current (version 7 or later) version of Acrobat Reader to access these documents.

Benefits                                                                                                                                          
Beneficiary Designation Form
Dependent Care Reimbursement Claim Form
Employee Tuition Waiver Application
Educational Assistance Program Application
Family Tuition Waiver Application
MESP 
Retirement Salary Reduction Agreement  (for full-time employees) 
Retirement Salary Reduction Agreement (for part-time employees)
Tuition Exchange Application  

Disability 
Short Term Disability Claim Application 
Long Term Disability 

Employee Information Changes
All changes are subject to verification.  Human Resources will submit the changes to all applicable healthcare and life insurance providers.  Since you are the owner of your retirement account at TIAA-CREF, HR is not able to make changes here.  You may make changes by logging in at www.tiaa-cref.org to update your profile.

• Home Address, Email Address & Phone Change - Login to Banner Self Service to make changes in Personal Information;
• Emergency Contact - Login to Banner Self Service to make changes in Personal Information;
• Kettering Alert - Login to Banner Self Service to make changes in Personal Information; 
• Family Status Change - Send an email request to askhr@kettering.edu.  Please describe the change (e.g. married, divorced, death, birth, etc.), the effective date, and any other relevant information (e.g. name of new family member, etc.).  Note:  A family status change may qualify for a change in your healthcare coverage outside the annual open enrollment period.  HR must be notified of such changes within 30 days of the qualifying event;
• Insurance Beneficiary Change - Complete the Beneficiary Designation Form and send it to Human Resources;
• Name Change - Send an email request to askhr@kettering.edu to notify HR of the name change. Please indicate if the name you would like to use is your "Legal name" or "Preferred name".  The University reserves the right to limit Preferred name changes. 

Employment
Candidate Reference Check - Faculty
Candidate Reference Check - Staff
Faculty Screening Ranking Worksheet
Interview Evaluation Form

Evironmental Health & Safety Forms

EH & S Incident Report

First Aid Kit Refill Order Forms
White Kit
Gray Kit
Lab & Custodial Kit