Human Resources

 

FORMS 

The following forms are available for download. The forms are organized into four categories: Human Resource/Payroll; Performance and Evaluation; Employment (student and temporary workers) and Miscellaneous. They are available in PDF, Excel and Word formats.

 

Human Resource/Payroll - (Employees Only)

 

Authorization for Direct Deposit (PDF)
Print and complete this form to authorize direct deposit of your paycheck. 

Criminal Record Disclosure Form 

Dickinson State University Salary Reduction Agreement (PDF)
Complete this PDF form to authorize a salary reduction and deferral to a 403(b) or 457(b) plan. 

Employee Spouse and Dependent Tuition Waiver Request (Excel)
Complete this Excel form if you are requesting a tuition waiver for a spouse and/or dependent. 

Employee Leave Record (Excel)
Complete this Excel form to record leave usage.  

Faculty Sick Leave Record (Excel)
Complete this Excel form to record usage of sick leave usage. 

Faculty Staff Tuition Waiver Request (Excel)
Complete this Excel form if you are a benefited employee requesting a tuition waiver for yourself. 

Leave Calculator (PDF)

Leave Donation Form (Excel)
Complete this Excel form if you are donating leave to another employee. 

Leave Donation Request Form (Excel)
Complete this Excel form if you are requesting donation of annual or sick leave. 

Leave in Advance Form
Complete this form if you are requesting leave in advance of accumulation.

Pay Dates for Adjuncts (PDF)

Pay Dates for Full-Time Employees (PDF) 

W-4 Form - Employees Withholding Allowance Certificate (PDF)
Complete this PDF form to choose the number of exemptions you are claiming. 

 

Performance And Evaluation (Employees and Supervisors)



Performance Development Review (Word)

Employee Feedback Report
Employees complete this Word form prior to their annual appraisal.

Position Description (Word)
Supervisors complete this Word form to describe the duties and responsibilities of a position.


 

Employment (Student and Temporary)



Authorization for Direct Deposit (PDF)
Print and complete this form to authorize direct deposit of your paycheck. This option is not available for international students at this time

Criminal Record Disclosure Form
Every new employee completes this form prior to employment.

Drug Free Policy
Every new employee completes this pdf prior to employment. (Please print this pdf in duplex mode if possible.)

Employee Demographic Information Form (Excel)
Every new employee completes this Excel form prior to employment.

Employee or Work Study Time Sheet Record (Excel)
Complete this Excel form to record hours worked in a pay period. This is used by students, temporaries (not adjunct faculty) and to record overtime for regular employees. 

Helpful hints for completing I-9
Use this to assist you in completing the I-9 Employment Eligibility Verification.

I-9 Employment Eligibility Verification (PDF)
Complete this PDF form to document your eligibility to work in the United States. 

International Student Employment Form
Used when hiring International Student Employees 

Memo of Understanding - 20-40 Rule
This form must be completed by the Supervisor and the International Student. 

Memo of Understanding Employment Policies and Regulations for International Students 


New Student Employee Paperwork Checklist
Check list to be used in making sure all the required paperwork is completed for hiring all student employees

Student Employment Form (Excel)
Supervisors complete this Excel form to record any event in student employment. This includes hiring, rehiring, job changes, pay rate changes or termination.

W-4 Form - Employees Withholding Allowance Certificate (PDF)
Complete this PDF form to choose the number of exemptions you are claiming. 

 

 

Miscellaneous Forms

 



Harassment Complaint Form
Complete this Excel form is you wish to file a complaint alleging violation of the DSU Harassment Policy.

Risk Management Incident Report Form (PDF)
Complete the PDF form SFN 50508 if you are injured or if you damage property while you are working.

Risk Management Motor Vehicle Accident Report Form (PDF)
Complete this PDF form SFN 51301 if you have an accident during work hours or in a State Fleet vehicle.