Benefits

Title Type Size
Affidavit of Domestic Partnership
pdf 95 KB DownloadAffidavit of Domestic Partnership
Certificate of Dependent Eligibility
pdf 227 KB DownloadCertificate of Dependent Eligibility
DROP Extension Form
pdf 161 KB DownloadDROP Extension Form
Employee Exit Information
pdf 171 KB DownloadEmployee Exit Information
FSA Claim Form-PayFlex
pdf 593 KB DownloadFSA Claim Form-PayFlex
Leave of Absence Request Form - Jury Duty, Military and FL Disaster Volunteer Leave ONLY
pdf 57 KB DownloadLeave of Absence Request Form - Jury Duty, Military and FL Disaster Volunteer Leave ONLY
Leave Without Pay Request and Instructions
pdf 203 KB DownloadLeave Without Pay Request and Instructions
Mail Order Prescription
pdf 246 KB DownloadMail Order Prescription
Mail Order Prescription Refill
pdf 106 KB DownloadMail Order Prescription Refill
Personal Health Application (PHA)
pdf 223 KB DownloadPersonal Health Application (PHA)
Request for Earned Degree Recognition
pdf 23 KB DownloadRequest for Earned Degree Recognition
Transfer of Sick Leave to Another Agency Request
pdf 52 KB DownloadTransfer of Sick Leave to Another Agency Request
TSA Transaction Routing Request
pdf 589 KB DownloadTSA Transaction Routing Request
Years of Service Credit Request
pdf 387 KB DownloadYears of Service Credit Request

Compensation

Title Type Size
Acting Stipend Request
pdf 279 KB DownloadActing Stipend Request
One Percent Increase Request Form
pdf 99 KB DownloadOne Percent Increase Request Form
Request for Change in Faculty Pay Level
pdf 85 KB DownloadRequest for Change in Faculty Pay Level

Employee Relations

Title Type Size
Nursing Mother Accommodation Request
pdf 81 KB DownloadNursing Mother Accommodation Request

Faculty

Title Type Size
Evaluation of Faculty-Librarian
docx 39 KB DownloadEvaluation of Faculty-Librarian
Evaluation of Teaching Faculty
docx 39 KB DownloadEvaluation of Teaching Faculty
Faculty Calendar of Work Days-Fall/Spring
xlsm 8690 KB DownloadFaculty Calendar of Work Days-Fall/Spring
Faculty Evaluation Guidelines
pdf 81 KB DownloadFaculty Evaluation Guidelines
Reimbursement for College Required Licensure
pdf 673 KB DownloadReimbursement for College Required Licensure

FMLA - Please contact the benefits department at Benefits@fscj.edu before downloading FMLA forms.

Title Type Size
Certification for Employee's Serious Health Condition
pdf 482 KB DownloadCertification for Employee's Serious Health Condition
Certification for Illness/Injury of Covered Servicemember
pdf 327 KB DownloadCertification for Illness/Injury of Covered Servicemember
Certification of Qualifying Exigency for Military Family Leave
pdf 226 KB DownloadCertification of Qualifying Exigency for Military Family Leave
FMLA Fact Sheet
pdf 97 KB DownloadFMLA Fact Sheet
FMLA Military Leave Fact Sheet
pdf 93 KB DownloadFMLA Military Leave Fact Sheet

Sick Leave Pool

Title Type Size
Joining the Sick Leave Pool
pdf 274 KB DownloadJoining the Sick Leave Pool
Physicians Report for SLP for Employees Not Currently on FMLA
pdf 210 KB DownloadPhysicians Report for SLP for Employees Not Currently on FMLA
Sick Leave Pool APM 03 1006
pdf 77 KB DownloadSick Leave Pool APM 03 1006

Student Employment

Title Type Size
Master Student Program Handbook
pdf 151 KB DownloadMaster Student Program Handbook
Student Worker Agreement
pdf 111 KB DownloadStudent Worker Agreement
Student Worker Confidentiality Agreement
pdf 117 KB DownloadStudent Worker Confidentiality Agreement
Student Worker Handbook
pdf 5535 KB DownloadStudent Worker Handbook
Student Worker Work Schedule
pdf 121 KB DownloadStudent Worker Work Schedule

Talent Acquisition

Title Type Size
Exemption from Public Records
pdf 157 KB DownloadExemption from Public Records
Name Change
pdf 58 KB DownloadName Change
Recruitment Reimbursement Form
pdf 790 KB DownloadRecruitment Reimbursement Form
Reference Check
doc 26 KB DownloadReference Check
Request for Secondary Job Approval (Exempt Employee)
pdf 36 KB DownloadRequest for Secondary Job Approval (Exempt Employee)
Task Order Form - Contingent Workers
pdf 119 KB DownloadTask Order Form - Contingent Workers
Task Order Form - Temporary Worker
pdf 84 KB DownloadTask Order Form - Temporary Worker
Veterans Preference Addendum
pdf 142 KB DownloadVeterans Preference Addendum
Work Schedule (Part Time Employees Only)
pdf 173 KB DownloadWork Schedule (Part Time Employees Only)