Employee Packages

Adjunct Packet

Classified Staff Packet

College Assistant/Tutor Packet

Full Time Instructional Staff/Faculty/ECP Packet

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DC37 Dental Claim

DC37 Health & Security Plan Short Term Disability Benefit Claim

Dental Claim Form: Guardian (PSC-CUNY)

Health Benefits Application

PSC-CUNY Welfare Fund Optical Reimbursement


Change of Address/Name

Change of Emergency Contact

Designation of Beneficiary for Non-Instructional Staff

Unused Annual Leave Benefit - Designation of Beneficiary for Instructional Staff


Application for Child Care Leave for Instructional Staff

Application for Child Care Leave of Absence for Non-Instructional Staff

Application for Fellowship Award

Application for Leave

Application for Paid Parental Leave

Application for Partial Disability Leave

Application for Partial Leave of Absence with Partial Pay

Application for Professional Reassignment Leave

Application for Professional Reassignment Leave in the Libraries

Application for Scholar Incentive Award (SIA)

Application for Special Leave for Personal Emergency for Instructional Staff

Application for Special Leave of Absence without Pay

Application for Temporary Disability Leave

Application for Travia or Terminal Leave

CUNY FMLA Leave Policy

FMLA Fact Sheet

FMLA Fitness for Duty Certification

Family and Medical Leave Act (FMLA Family)

Family and Medical Leave Act (FMLA)

Family and Medical Leave Act (Military)

Jury Duty Form

Leave Record for Non-Teaching Staff

Leave Record for Teaching Instructional Staff



Federal W-4 Form

New York State and New York City IT-2104 Form

Overtime Summary Sheet

Overtime Summary Sheet-PSC

Tax Certification for Foreign Nationals

W-2 Duplicate Request


Determining Excessive Lateness or Excessive Absence

Employee Counseling Memorandum

Employee Warning Form

General Guidelines for Merit Increase

Guidelines for Merit Increases for Civil Servants

Managerial Performance Standards

Performance Evaluation Form - CUNY Office Assistant (In Academic Offices)

Performance Evaluation Form - Sub-Managerial Supervisory Positions (B&G)

Performance Evaluation Memorandum - CLT Only

Performance Evaluation Memorandum-HEO Series

Post-Observation Conference Memorandum

Probationary and Service Report

Staff Review Screening Form

Teaching Faculty Observation Report

Workload/ Position Classification Review - Higher Education Officer Series Titles


Application for Adjunct Promotion

Application for Faculty Promotion

Promotion Application Packet for Full Time Faculty


Full Time Faculty Workload Report

Multiple Position Form for Full-Time Faculty

Multiple Position Policy Summer Assignment Reporting Form

Workload Report Form for Adjunct Faculty and Graduate Teaching Fellows

Worker's Compensation

Election of Rate of Charge Against Annual and/or Sick Leave Balances

Workers' Compensation Claim Initiation - Accident Description Codes

Workers' Compensation Claim Initiation - Employee Statement Form

Workers' Compensation Claim Initiation - Witness Statement Form


Application for Employment Short Form

Authorization for Release of Information

Authorized Signatures to approve regular Time and Leave Records

Employee Clearance Check list and Exit Interview Form

Employee Time Report On-Line Entry

Helpdesk Form - Accounts, Updates, Passwords and BMCC ID Card

Inter-College-Transfer Policy

Intra-College-Transfer Policy for Gittleson Staff

Personnel Action Form

Report of External Employment for Classified Staff

Tuition Fee Waiver

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Borough of Manhattan Community College
The City University of New York
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