NOTE: Some of these form links will take you to a site away from the MUW website.
| Background Check Release Authorization | Call Human Resources x7222 |
| Banner Access Request | Electronic Form is available on the ITS Website. Select Banner, then Banner Access Request. |
| Banner Self-Service Instructions: | |
| Pay Stubs | [PDF] |
| W-2 | [PDF] |
| BENEFIT Forms: | |
| Benefits Election Form (all benefits EXCEPT State & School Employees’ Health/Life) | [PDF] |
| Claim Forms | Dental (Guardian), Vision (Davis), Disability, Term Life (call HR Generalist x7222) |
| Guardian – Dental, Vision (Davis), Term Life, Accident | Guardian PDF |
| MedMutual – Cancer, Critical Illness | Cancer PDF Critical Illness PDF |
| Reliance Standard – Disability, Term Life | Disability PDF Term Life PDF |
| State & School Employees’ Health Insurance Application | Health PDF |
| State & School Employees’ Life Insurance Application | Life PDF |
| State & School Employees’ Life Insurance Beneficiary Designation (Minnesota Life/Securian) | Click here for instructions to change your beneficiary designation on-line. Or, complete the [PDF] form and submit to Human Resources. (Links take you off-site.) |
| State & School Employees’ Health Insurance & CVS Caremark Online Registration | Click here for instructions to create an account and access electronic insurance cards. |
| Confidentiality Agreement | [PDF] |
| Deferred Pay Form (Faculty) | [PDF] |
| Direct Deposit Authorization Form | Call Human Resources x7222 |
| Employee Certification and Authorization Form | [Word] |
| Employee Date Change Form (For name, address, phone, email changes) | Call Human Resources x7222 |
| Employee Personal Information Form | [PDF] |
| Employee Transfer Checklist – Current Department | [Word] |
| Employee Transfer Checklist – Receiving Department | [Word] |
| Employee Time Log (For all Benefits-Eligible Biweekly Employees) | Email cajernigan1@muw.edu for a copy of the time log. |
| Employee vs Independent Contractor Checklist | [Word] |
| Flex Time Approval Form | [Excel] |
| Job Evaluation Packet | [PDF] To maintain fillable fields, use the save option vs printing as a pdf. Email hrinfo@muw.edu if you don’t have this option. |
| Justification and Approval for Adjunct Teaching or Additional Duties (Staff) | [PDF] |
| Leave – Application for Leave | [PDF] |
| Leave – Instructions for Entering & Approving Leave in Banner Self-Service and Leave FAQs | [PDF] |
| Leave Form – Biweekly Non-Exempt Employee Attendance/Leave Record | [Excel] or email cajernigan1@muw.edu for a copy of the12-month master spreadsheet. |
| Leave Correction/Late Forms: | |
| Exempt Employee Form | [Excel] |
| Less Than 12 Month Faculty Form | [Excel |
| Non-Exempt Employee Form | [Excel] |
| Leave Donation Eligibility Form | [PDF] |
| Leave Donation Form (Staff) | [PDF] |
| Leave Donation Form (Faculty) | [PDF] |
| Leave Guidelines | [PDF] |
| Meal Plan Form | [PDF] |
| Medical Certification Form (Employee) | [PDF] |
| Medical Certification Form (Family Member) | [PDF] |
| Notice of Intention to Return from Medical Related Leave | [Word] |
| Onboarding Checklist for Supervisors | [Word] |
| Personnel Action Form (PAF) | [PDF | Word (fill-in format)] |
| PERS Form 4A | [PDF] |
| Reasonable Accommodations Request Form | [PDF] |
| Request for Outside Employment – Consultation and Research (Faculty) | [Word] |
| Request for Outside Employment (Staff) | [Word] |
| Sponsored Programs Personnel Action Form | [ PDF | Word] |
| Student Worker Time Log (Time Entry Time Sheet – Use as Excel Document – Do Not Handwrite) | [Excel] |
| Summer Flex Program Guidelines, Examples, and FAQs | [PDF] |
| Summer Flex Schedule Request Form | [Excel] |
| Tax Deferred Annuity Form (for new TDA or change) | [PDF] |
| Tax Form – Form W-4 Employee’s Withholding Allowance Certificate | Link takes you to an off-site link. Form W-4 2024 |
| Tax Form – Mississippi Withholding Exemption Certificate | Link takes you to an off-site link. MS Tax Withholding Form |
| Teleworking – Job Analysis | [Word] |
| Teleworking – Temporary Agreement | [Word] |
| Tuition Remission Form (Employee/Retiree) | Form is available on the Financial Aid website under Forms. Financial Aid Forms |
| Tuition Remission Form (Dependent Child) | Form is available on the Financial Aid website under Forms. Financial Aid Forms |
| Tuition Remission Form (Spouse) | Form is available on the Financial Aid website under Forms. Financial Aid Forms |
| Veteran’s Self-Identification Post-Offer Form | [PDF] |
| Voluntary Self-Identification of Disability Form | Link takes you to an off-site link. DOL Voluntary Self-ID Form |
| Workers’ Comp Form – First Report of Injury (Form & Instructions) Complete all applicable yellow highlighted boxes and SUBMIT TO THE HUMAN RESOURCES OFFICE. | [PDF] |
Notes:
– PDF format is PRINT ONLY which requires free Acrobat Reader
– Right click on “Excel or Word file” and save the file to a local directory
– For Word Fill-in Forms – Save form to your computer, in Word, on the “Forms” toolbar, click the “lock” or “protect form” once document is open.