General HR Forms

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Benefits Forms	Classification & Compensation Forms	Employment Process Forms
General HR Forms	Payroll Forms	Records Forms
Professional Development Forms	Evaluation Forms

Benefits Forms

• ACCMPP Distribution Election Form Adjunct Faculty & Hourly Personnel Only
• ACCMPP Beneficiary Designation Form
• ACC Beneficiary Designation
• ADAAA Accommodation - Certification of Physician
• AFLAC
  • Instructions for Filing Claim (PDF)
  • Accidental Injury Claim Form (PDF)
  • Sickness Claim Form (PDF)
• TRS Retirement Checklist (PDF)
• ORP Retirement Checklist (PDF)
• Salary Reduction Agreement
• Sick Leave Pool Donation
• Teacher Retirement System of Texas (TRS) Designation of Beneficiary (TRS-15) (PDF)
• Funds Transfer Authorization
• Privacy Rooms Memo (PDF)

If you have any questions about ACC's Benefit program, please contact Susan Corbett at (512) 223-7617, Alisol Martinez at (512) 223-7800, or Prisca Baker at (512) 223-7537.

Classification & Compensation Forms

• Compensatory Time Report For Professional-Technical Employees
• Position Change and Budget Approval Form This form is not part of the Annual Budget process.
  NOTE: This form replaces the previous Position Budget Approval form, effective June 30, 2004. It serves the same function as the old form, but has expanded application to include any change to a position that occurs outside the normal budget process. Contact Vicki West, Compensation Manager at 223-7502, or vwest@austincc.edu if you have any questions regarding using this form.
• Temporary Assignment Pay (TAP) Recommendation

Employment Process Forms

Staff Employment

• ACC Application for Employment (PDF)
• Hiring Committee Membership (PDF)
• Employment Interview Evaluation (PDF)
• Employment Reference Check (PDF)
• Hiring Committee Chair Checklist (PDF)
• Interview Rating--Weighted Approach (PDF)
• Interview Schedule (PDF)
• New Employee Orientation Checklist (PDF)
• Drug Test Request Form (PDF)

Faculty Employment Forms

• Authorization for Criminal History Background Check (PDF)
• Communication Log (PDF)
• Faculty Committee Membership (PDF)
• Faculty Employment Reference Check (PDF)
• Faculty Employment Interview Evaluation (PDF)
• Faculty Credential Certification (PDF)
• Interview Rating--Weighted Approach (PDF)
• Interview Schedule (PDF)
• Request for Specialty Advertising (PDF)
• Drug Test Request Form (PDF)

Adjunct Faculty Employment Forms

• New/Returning Adjunct Hiring Paperwork Checklist (PDF)
• New Adjunct Faculty Information (PDF)
• Faculty Committee Membership (PDF)
• Faculty Employment Reference Check (PDF)
• Faculty Employment Interview Evaluation (PDF)
• Adjunct Faculty Application Evaluation (PDF)
• W-4 Employee's Withholding Allowance Certificate (PDF)
• I-9 (Employment Eligibility Verification) (PDF)
• Adjunct Faculty Conditions of Employment (PDF)
• Faculty Credential Certification (PDF)
• Authorization Agreement for Direct Deposit
• Drug Test Request Form (PDF)

If you have any questions about ACC's employment process, please contact Erica Breedlove at ebreedlo@austincc.edu or (512) 223-7015.

Payroll Forms

• ACC Scholarship Funds--Payroll Deduction (PDF)
• Authorization Agreement for Direct Deposit (PDF)
• Parking Permit Payroll Deduction (PDF)
• Request for Late Approval of ACCeTime (PDF)
• Retiree Checklist (PDF)
• Summary of Absence (PDF)
• Supplemental Check Request (PDF)
• Paper Timesheet (PDF)
• W-4 Employee's Withholding Allowance Certificate (PDF)
• W-5 Earned Income Credit (PDF)

Records Forms

• Name Change Notification
• Hourly Employee Information
• Change of Employee Information (You must login to Online Services)
• Credential Certification (PDF)
• Educational Recognition Award
• Employee Leave Request
• Employee Separation
• Supervisor's Exit Checklist
• House Bill 638
• I-9 (Employment Eligibility Verification)
• W-4 Employee's Withholding Allowance Certificate (PDF)

General HR Forms

• Request for Mediation: This form is also available in the Campus Manager's Office on each campus or from HR at HBC.
• Statement of Grievance: This form is also available in the Campus Manager's Office on each campus or from HR at HBC.
• Statement of Complaint: This form is also available in the Campus Manager's Office on each campus or from HR at HBC.
• Request for Emergency Funds for Classified, Prof-Tech and Faculty

Professional Development Forms

Professional Development Report Forms

• Activity Report
• Summary Report

Mentoring Forms

• Mentor Checklist
• Mentee Checklist
• DL Mentor Checklist
• DL Mentee Checklist
• Mentor Assignment Form
• Optional Mentor Evaluation
• Optional Mentee Evaluation
• Teaching Observation Checklist

Sabbatical Forms

• Sabbatical Leave Application Checklist for Faculty
• Sabbatical Application Submission & Timeline for Faculty
• Sabbatical Leave Application for Faculty
• Sabbatical Leave Application Checklist for Staff
• Sabbatical Application Submission & Timeline for Staff
• Sabbatical Leave Application for Staff

Evaluation Forms

Staff Evaluation Forms

• PEP Goals Form
• PEP Employee Performance Review Form
  

Faculty Evaluation Forms

Surveys by Instructional method- These are samples of the Faculty Evaluation Assessment Instruments used in the classroom.

• Form A - Lecture Only Form - Evaluation form for Lecture Only courses.
• Form A - Lecture & Lab Form - Evaluation form for Labs, and Lecture/Lab courses
• Form B - Clinical Form - Evaluation form for Clinical instruction.
• Form C - Open Campus Form - Evaluation form for Distance Learning courses.

Observation Checklists

• Classroom Observation Checklist (PDF)
• Lab Observation Checklist (PDF)
• Clinical Observation Checklist (PDF)

Portfolio/ Input Forms

• Administrative Input Form (PDF) - This form allows input to departments regarding faculty performance. This form is optional.
• Evaluation Summary Form for Full-Time Faculty
• Evaluation Summary Form for Adjunct Faculty
• Faculty Input Form downloadable version (MS Word)
• Faculty Input Form printable version (PDF)
• Instructional Input Form (PDF)

Request for Evaluation - Please submit Spring and Summer Faculty Evaluation Requests as early as possible to insure sufficient time for the evaluation department to prepare and distribute the evaluation packets.

Counselor Forms

Counselors

• Evaluation of Counseling Faculty - used to complete a self-evaluation.
• Workshop Facilitator's Summary - used to summarize workshop data.

Dean of Student Services

• Evaluation of Counseling Faculty  - used to evaluate counselor performance.
• Counseling Session - used to evaluate individual counseling session.
• Workshop Evaluation - used to evaluate counseling workshops or other sessions.

Student

• Counseling Session - used to evaluate the counselor’s service.
• Workshop Evaluation - used to evaluate counseling workshops.

Librarian Forms

• Annual Performance Review Form
• Evaluation Summary Form