Forms

Forms for the use of Wagner College employees

Accident Reporting & Treatment (ART) Form — use during the Accident Investigation stage for reporting a workplace injury.

Administrative Monthly Time Report — to report all exempt administrative employees benefit time on a monthly basis.

Authorization for Release of Medical Information — to authorize the College to obtain medical information for the sole purpose of determining reasonable accommodation needs under the American with Disabilities Act. Please note that your employment at Wagner College is not for any specific period of time, and this letter does not constitute an annual contract, since you are employed in accordance with the needs of the College.

Bid Form — to be considered for an open position on campus (current employees only).

Declaration of Domestic Partnership — to establish the existence of a domestic partnership for the purpose of benefit eligibility.

Declaration of Termination of Domestic Partnership  — for canceling a previously filed Declaration of Domestic Partnership.

Employee Annual Fund Campaign Gift Form — for any employee wishing to make a contribution to the College's Annual Fund.

Employee Request for Reasonable Accommodation — to request a reasonable accommodation under the provisions of the American with Disabilities Act (ADA).

Employment Eligibility Verification — As required by the Immigration Reform and Conrol Act of 1986, all new hires must fill out this form, also known as the I-9. The form is used to verify the eligibility of the individual for the employment in the United States.

Employee Warning Notice — used by supervisors wishing to document an infraction by an employee.

Employee's Withholding Allowance Certificate (W-4) — to determine the correct income tax withholdings.

Exit Interview — completed by all employees terminating their employment relationship with the College.

FMLA Certification of Healthcare Provider — used by the medical provider of an employee filing for FMLA (Family Medical Leave Act) leave.

FSA Enrollment Form — to participate in the Flexible Spending Account program.

FSA Reimbursement — to be reimbursed under the Flexible Spending Account program.

Job Performance Evaluation Form - Exempt  — to evaluate the performance of all administrative exempt personnel.

Job Performance Evaluation Form - Non Exempt — to evaluate the performance of all non exempt staff personnel.

NY Employee's Withholding Allowance Certificate — to specify allowances for New York City, New York State and Yonkers income tax.

Payroll Direct Deposit Authorization — to request that your payroll check be deposited directly into your savings or checking account.

Personal Data Form — used by the Human Resources Office to collect employees' personal data.

Staff Time Sheets — used by all non-exempt, non-union staff employees to record and report their time worked on a weekly basis.

WC Supervisor's Report of Injury — to report an employee's workplace injury.



If you have any questions or concerns about any of the forms please contact the Office of Human Resources.