Forms
*Some fillable PDF forms should be downloaded locally to be filled out as they will not display in some Adobe Reader browser plugins properly.
Adjunct Forms
- Adjunct Benefits Information and Forms
- Adjunct Workload Reporting Form (pdf)
- Two-year and Three-year Appointments for Teaching Adjuncts *(pdf)
- FAQ: Three-year Appointments for Teaching Adjuncts (Fall 2018–Spring 2021) (pdf)
- Adjunct Appointment Timeline for Winter and Spring 2021
Annual Leave Request Forms
Benefits and Leave Forms
Benefits Forms
- Health Benefits Application/Change Form (pdf)
- 2023 CUNY Voluntary Savings Plans—Universal Availability Notice (pdf)
- 2023 Salary Reduction Agreement (pdf)
- COBRA - Continuation of Coverage Application (pdf)
- PSC-CUNY Change of Status (pdf)
- Other Forms
For more updated information and the New Employee HIP HMO Opt-Out Request Form, visit the Benefits Important Notices page.
Leave Forms and Information
- Annual and Sick Leave
- Bereavement Leave
- Catastrophic Sick Leave
- Child Care Leave (Unpaid)
- Dedicated Sick Leave
- Family Medical Leave Act (FMLA)
- Jury Duty
- Paid Family Leave
- Paid Parental Leave (PPL)
- Special Leave of Absence without Pay for Faculty (pdf)
Change of Address / Personal Information
- Basic Personnel and Address Information (pdf)
- Gender Change Request Form *(pdf)
- Preferred Name Request Form *(pdf)
- Retiree Change of Address Form (pdf)
CUNY Employee Tuition Fee Waiver
CUNY Work/Life Program Employee Mediation Referral
Direct Deposit
Employee of the Month
Employment Verification
Faculty Academic Leaves
The Office of the Associate Provost for Faculty and Administration website contains information about the following leaves of absence:
- Fellowship Leave Application
- Scholar Incentive Awards
- Special Leave of Absence without Pay
Graduate Assistant
HEO Labor Management Committee Forms
- HEO Series Application for Assignment Differential (pdf)
- HEO Reclassification Form (pdf)
- Workload Concerns for HEO Series (pdf)
Multiple Position Application for HEOs, CLTs, and Research Assistant/Associates
- Memo: Change from Overload Appointment Authorization to Application for Multiple Position (pdf)
- Application for Multiple Position (pdf)
New Employee Forms
- Amended Constitutional Oath (pdf)
- Amended Constitutional Oath - Instructional (pdf)
- BC Email Application (pdf)
- Benefits - Classified Full Time (pdf)
- Benefits - Classified Part Time (pdf)
- Benefits - Instructional Staff Full Time (pdf)
- CUNY Employment App - Part One & Two (pdf)
- CUNY Employment App - Part Three (pdf)
- CUNY Employment App - Part Four (pdf)
- CUNY External Employment Form (pdf)
- CUNY Policy Receipt (pdf)
- Emergency Contact Information (pdf)
- Emergency Evacuation Assistance (pdf)
- Fingerprinting Procedures (pdf)
- I-9 List of Acceptable Documents (pdf)
- IT Security Orientation (pdf)
- Personal Data Form (pdf)
- Self-Identification Disability Form (pdf)
- Self-Identification Ethnicity Form (pdf)
- Self-Identification Veteran Form (pdf)
- Sprintax (pdf)
- Statement of Citizenship (pdf)
Overtime Request Forms
Payroll Forms
- Tax: Federal (W-4) (pdf)
- Tax: New York State/New York City (IT-2104) (pdf)
- Tax: New York State/New York City (IT-2104-E (exempt) (pdf)
Performance Evaluations
- Classified Managerial Evaluation Form (pdf)
- Classified Staff Evaluation Form (pdf)
- Campus Peace Officer Evaluation Form (pdf)—For Sergeants, Officers, CPOs and CPAs
- CLT Evaluation Form (doc)
- HEO Evaluation Form (pdf) (doc)
Person of Interest (POI) Request
Reasonable Accommodations / General Accommodation
Reasonable Accommodations
Refer to Human Resource Policies for more information.
- Reasonable Accommodations Request Form (pdf)
- Reasonable Accommodations—Health Care Provider Assessment Form (pdf)
General Accommodation
