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Forms
Benefits
2012 Continuation of Insurance Benefits
Affidavit of Domestic Status
Dental - MedBen Application (add/drop)
Disability Insurance, Long-term, Employee Application (coming soon)
FSA - Flexible Spending Plan Enrollment
FSA - Dependent Expense Reimbursement Request
FSA - Premium Expense Reimbursement Request
FSA - Medical Expense Reimbursement Request
Leave Donation Form
Life Insurance, Employee Application for Supplemental Coverage (coming soon)
Medical - Anthem Enrollment Application (coming soon)
Medical - Anthem Plan Change Application (add/drop) (coming soon)
Medical - Health Savings Account Enrollment
Medical - Health Savings Account Direct Deposit Info
Medical - Premium Certification 2012
Retirement - Salary Reduction Agreement
Sabbatical Request Form
Tuition Remission Application
Vacation and Sick Leave Form
Vision - MedBen Application (add/drop)
Vision - MedBen Claim for Reimbursement
Payroll
Core Payroll Form
Direct Deposit Authorization Form
I-9 Form
Payroll: Bi-Weekly Schedule
Payroll: Staff Time Sheet
W-4 Form
Performance Feedback
Performance Development Program (PDP) Form
Performance Development Program (PDP) Reference Guide
Employment
Employment Application
Library Card Request Form
Position Authorization Form
Request for Employment Reference
Professional Development
Faculty Professional Development Payment Form
Faculty Professional Development Request Form
Other
Phased Retirement Program Application for Faculty Members
Phased Retirement Program Application for Administrative Staff Members
Tuition Exchange Precertification Form
Tuition Exchange Guidelines
© 2012 Antioch University New England, 40 Avon Street, Keene, NH 03431-3516 800.553.8920