HUMAN RESOURCES FORMS

• Address Change Form
  • KERS Address Change Form
  • KTRS Address Change Form
• Direct Deposit Form
• Employment Offer Letter Template Exempt Positions
• Employment Offer Letter Template Non-Exempt Positions
• Employee Performance Evaluation Form
• Form I-9, Employment Eligibility Verification revised 6.16.08
• Request for New Position/Reclassification
• Retirement System New Membership Applications
  • KERS Form 2001 & 2035 (both required)
  • KTRS Form F-1
• Richmond City Tax Exemption Form
• Self-Identification Form
• Employee Separation Notice Word PDF
• State and Federal Tax Forms
• Supplemental or Consultant Services Pay Request

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Health Insurance Forms

• Anthem Application *
• Claim Form
• Express Scripts: EKU Prescription Drugs Manager*
• Over-the-Counter Drug Listing Form *
• Delta Dental Application & Information
• Chard-Snyder (Flexible Spending) Application

Other Benefit Forms

• Faculty & Staff Tuition Waiver Form (for EKU courses) * revised 6.26.08
  • Use this form for academic credit courses at EKU (see form for details)
• Faculty & Staff Tuition Waiver Form (for non-EKU courses) *
  • Use this form for academic credit courses through or at other KY public universities/colleges (see form for details)
• Sick/Vacation Form

Performance

• Performance Evaluation Form
• Corrective Action Form
• Employee Assistance Program Mandatory Referral Form

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