All forms requiring signatures must be printed out, signed, and sent to the appropriate department. Please call Human Resources at 358-2877 with any questions.
- Staff CERP and Severance Program Descriptions
- Faculty CERP and CESP Program Descriptions
- COVID-19 Employee Training and PPE Requests
- Requesting a COVID Related Work Accommodation
- Connect to WISE
- Connect to PeopleAdmin
- Employment Verifications
- Reporting an Accident or Injury
- Personal Information Forms
- Performance Management Evaluation Process and Forms *
- Position Descriptions (PD)
- Hiring Related Forms
- Time and Leave Reporting
- Compassionate Leave
- Medical Leave Forms
- Search Forms
- Pick-up Forms
Staff CERP and Severance Program Descriptions
Faculty CERP and CESP Program Descriptions
COVID-19 Employee Training and PPE Requests
Requesting a COVID Related Work Accommodation
The Request Process
Once a COVID-19 Work Accommodation Request form has been returned to Human Resources for the following reason:
- Because I have a serious health condition that puts me at a greater risk for COVID-19 or;
- Because I am cohabitating with someone who has a serious health condition that put them at a higher risk for COVID-19 or;
- Because I have a documented mental health condition supporting that it is unhealthy for me to return to campus at this time, Human Resources will:
- HR acknowledges receipt of the work accommodation request via e-mail notification to the employee.
- HR will review the work accommodation request and supporting documentation received and will reach out to the employee if additional documentation is needed.
- Once reviewed, HR will respond to the work accommodation request with either an approval or denial via e-mail notification to the employee within 3 days of receiving all required supporting documentation.
- If work accommodation is approved, HR will communicate approval to the supervisor and copy the employee via e-mail notification.
- Because I am caring for my child whose school or place of care is closed (or provider is unavailable) due to COVID-19 related reasons,
Human Resources will:
- HR acknowledges receipt of the work accommodation request via e-mail notification to the employee.
- HR will review the work accommodation request and supporting documentation received and will reach out to the employee if additional documentation is needed.
- Once reviewed, HR will respond to the work accommodation request with either an approval or denial via e-mail notification to the employee within 3 days of receiving all required supporting documentation.
- If work accommodation is approved, HR will communicate approval to the supervisor and copy the employee via e-mail notification.
- The employee should contact MetLife to initiate a claim for FFCRA (888-608-6665) (The Families First Coronavirus Response Act (FFCRA) provides eligible employees of the University System of New Hampshire who are actively at work with paid sick leave and/or expanded family and medical leave for specified and qualifying reasons related to COVID-19. These provisions will apply from 4/1/2020 through 12/31/2020.)
Complete and Submit the Request Form
Download, complete and submit the Word Accommodation Request form.
Connect to WISE
WISE, Web Self Service for Employees is available so employees may update their personal information, emergency contact data, and submit hourly timesheets or apply approvals.
Connect to PeopleAdmin
Internal resources for KSC faculty and staff.
Employment Verifications
- Keene State College/USNH Employment Verifications
- Online verification at i2verify.com
Reporting an Accident or Injury
Any employee who is involved in an accident or is injured in the workplace is covered by Worker’s Compensation. Employees should complete an Incident Report Form. Incident Reports should be completed by the employee and his/her supervisor and filed with Human Resources within two days of the accident/injury. If non-urgent medical attention is required, employees are urged to use the Emergency Room or the Occupational Health Department at the Dartmouth-Hitchcock Clinic in Keene. For further information, contact Karyn Kaminski.
Personal Information Forms
- Name Change Form
- Address Change Form
- Personal Information Sheet – New Employees
- Emergency Contact Sheet Provide us with up-to-date information about whom to contact in the case of an emergency.
Performance Management Evaluation Process and Forms *
* Please Note: The new staff performance evaluation form is for both PAT and OS staff.
- Performance Review Process – Employee Guide
- Performance Review Process – Supervisor Guide
- Performance Management Guidelines
- Staff Performance Evaluation Form
Position Descriptions (PD)
- Position Descriptions can be accessed via the PeopleAdmin system PeopleAdmin,
Hiring Related Forms
- Appointment Request Form – CHASE, Adjunct Non-Exempt (Hourly) Appointments
- Appointment Request Form – CSSA, Adjunct Exempt (Salaried) Appointments
- Staffing Plan Form- for Adjunct Staff Appointments
- Student Hire Request Form
- I-9 Employment Eligibility Verification (US Gov. Form)
- W-4 Form (New IRS Form for 2021)
- Bonus Request Form
- Direct Deposit NET PAY Form
- Direct Deposit FIXED AMOUNT Form
- KSC Request for Additional Pay for Administrative Stipend or Adjunct Appointment Duties
- Position Action Form-All Positions
- Mailing Label/Employee List Request Form
Time and Leave Reporting
PAT Leave Reporting Using WISE
- How to record and submit your PAT leave usage using the USNH Wise website.
Kronos Information and Resources
Compassionate Leave
The Compassionate Leave Policy was established in 2006 to provide an avenue for Keene State staff to help each other out in times of need.
- Compassionate Leave Verification to be completed by employee receiving a Compassionate Leave donation.
- Compassionate Leave Donation to be completed by the employee donating time to another employee.
Medical Leave Forms
- Family/Medical Leave Request
- FMLA Certification of Health Provider
- Authorization for Release of Information (HIPAA)
Search Forms
- Please contact Human Resources at 358-2471
Volunteer Forms and Notices
- Volunteer Notification Letter
- For additional volunteer opportunities please visit the Alumni page
Pick-up Forms
The following forms must be picked up at Human Resources:
- Candidate Recommendation/Rejection Matrix for All Interviewees
- Faculty/Staff Non-Credit Tuition Waiver Form
- Adjunct Tuition Waiver (if eligible)
Benefit providers have additional forms (or links on their webpages) specific to those plans. Contact Karyn Kaminski for assistance.