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Forms

Pre-Employment/Volunteer Background and Clearance Policy:

Effective January 1, 2015, the University will follow the procedures outlined in University Policy G021 (attached) as required by Board of Governors' Policies 2014-01-A: Protection of Minors, and 2009-01. All prospective employees and volunteers are required to have the following background screening clearances:

1. A criminal history record check from the Pennsylvania State Police (PSP) or statement from the PSP that the individual has not been convicted of a reportable offense.   

2.  Certification from the Department of Human Services (formerly Department of Public Welfare) as to whether the individual is named in the statewide database as a perpetrator in a pending child abuse investigation or in a founded or indicated report of child abuse within the last five years.

3.  A federal criminal history record check. The individual must submit a full set of fingerprints to the PSP (via contractor Cogent, Inc.) to obtain this report. The PSP will submit the fingerprints to the Federal Bureau of Investigation for the purpose of verifying the identity of the individual and obtaining a current record of any criminal arrests and convictions.

All forms related to these clearance are available at the Pennsylvania Department of Human Services website at:  PA DHS

Functional Capacity pre-employment:
 Health Care Forms:  
PASSHE Healthcare Related Forms:
Flexible Spending Account Forms:
Retirement Plan Allocation Change Form (for ARP Participants):
Tuition Waiver Forms:
COBRA:
HIPAA Notices:

Additional forms are also located on the myEdinboro Portal at this link.