RN to BSN Program
Employment Forms:
- Employee Information Change Form
- University Job Description Form
- Non-Instructional Authorization to Fill a Vacancy
- Position Reclassification Request Form
- Bid Form (AFSCME, OPEIU, PSSU, and SPFPA)
Faculty Forms:
- Distance Education Compensation Form
- Dual Employment Form
- Faculty Approval Process (Part-time Teaching in Other Departments) Form
- Faculty Load Change Form
- Windshield Time Request - Incentive Pay Form
Health Care Forms:
- PEBTF-2 Employee Enrollment/Change Form (AFSCME, SCUPA, PSSU, PDA)
- PEBTF Coordination of Benefits Form
- PEBTF Declaration of Spouse Health Coverage (Employees Hired on or after 8/1/2003)
- PEBTF Declaration of Spouse Health Coverage (Employees Hired on or before 7/31/2003)
- PEBTF Student Certification Form
- National Clearinghouse Instructions for Student Verification
PASSHE Healthcare Related Forms:
- PASSHE Enrollment/Change Form
- PASSHE Student Certification Form
- National Clearinghouse Instructions for Student Verification
- Affidavit of Residence and/or Dependency for "Other Children"
Flexible Spending Account Forms:
- Reimbursement Form for Dependent Care Reimbursement Account
- Reimbursement Form for Medical Reimbursement Account
Retirement Plan Allocation Change Form (for ARP Participants):
Tuition Waiver Forms:
- Edinboro University of Pennsylvania Tuition Waiver
- Faculty (or dependent) attending other State System Schools
- Management dependent children (only) attending other State System Schools
- Flex Schedule
(Application of Flex Schedules & Alternate Work Schedules)
