Forms

Contractor Access Form

For use in hiring contractors.

Zero Pay/Volunteer Form

For use in appointing all unpaid affiliates and volunteers.

Insurance Forms

Link to ALL PEBA Insurance Forms.

PEBA Notice of Election Form 

Insurance enrollment or changes.

Affordable Care Act Request for Review of Healthcare Coverage Eligibility

and Process

Appeal form for ACA eligibility and process.

PEBA Certificate Regarding Tobacco Use

Certification of Non-Tobacco/Tobacco Use.

SC Public Employee Benefit Authority (PEBA) Name/Address Change

PEBA Name/Address Change form. Employees can also update their addresses for Insurance purposes by visiting MyBenefits.

State Health Plan Benefits Claim Form and Instructions

Prescription Drug Reimbursement/Coordination of Benefits Claim & Form Instructions

Prescription Drug Home Delivery Order Form

PEBA COBRA Notice of Election form

PEBA COBRA Rates Chart

PEBA State Dental Claim Form and Instructions

PEBA Notice of Election Form

MoneyPlu$ Claim Form

Retirement Forms

Link to ALL retirement forms.

Enrollment Form

For Use in ALL systems.

Beneficiary Form

For use in ALL systems, except State Optional Retirement Plan.

Beneficiary/Trustee Designation Form

For use in ALL systems, except State Optional Retirement Plan.

Election of Non-Membership

PEBA Election of Non-Membership form.

State Optional Retirement program (ORP) Active Group Life Beneficiary Form

SC ORP Active Incidental Death Benefit Beneficiary Designation.

Amount Change form for Supplemental Retirement Account

College's Annuity Amount Change form. (401K, 457, and/or 403b)

Employee Bonus/Award Request Form

State-funded bonuses:

• May only be given to Permanent Employees.
• May not exceed $3,000 in one fiscal year.

Faculty/Staff Awards must comply with Board of Trustees' approved guidelines, and may be used for all employees.  

Compensatory Overtime Record

Used to track compensatory time for Exempt employees.  The College is not required to provide compensatory time or pay to Exempt employees.

Non-Exempt employees must record all hours worked on their timesheets in BANNER.

Request to Change Accrual Type

Request for Additional Pay

Request for Salary Change

Used for permanent employees only.

• Increases are limited to 0-15% of base salary.  Final salary may not exceed the maximum of the assigned pay band.
• Reasons for salary changes include additional duties/skills, performance, promotion, reassignment, upward reclassification, or retention. 
• In some circumstances, a salary reduction may also be appropriate.  Please consult HR prior, if you believe this to be the case.

Request for Temporary Salary Adjustment 

Used for permanent employees only.  TSAs are short-term adjustments in rate of pay to compensate an employee for taking on additional duties within their own Department:

• Duties should be performed during normal business hours and are similar in nature to employee's primary duties, but often of a higher level or greater volume.
• TSAs cannot exceed more than one year, or exceed 15% of the employee's salary for the period of time.

Request for Internal Dual Employment (RIDE)

Used for permanent employees performing internal dual employment by working for a separate department (or in isolated cases, within their primary department) to perform independent additional duties that are not related to the work performed in their primary position.

Reasonable Suspicion Checklist

For use in instances where alcohol/drug use is suspected, and employees are unfit to perform their duties.

Employment Verification Release

SR&I Background Check Request

Request for Temporary Employee Posting/Hire Authorization

Hire Authorization Form is not required for classified staff and temporary PeopleAdmin recruitments

Faculty Hire Authorization Form

FTE Request Form

Adjunct Appointment

Temporary Appointment (all required forms)

Used for hiring and employing individuals on a temporary basis to do non-teaching work that is not assigned to a permanent employee:

• Appointments may not exceed 12 months, but can be renewed.  Temporary employees (part and full-time) must have a break-in-service of no less than 15 working days after one full year of employment.
• Job Description and source of funding information is required.
• Recruitment is not required for temporary positions.

Temporary Appointment Renewal Form

Used only for renewal of existing employees actively under temporary contract with the College.

Attach to new temporary appointment forms, unless the position is being recruited through People Admin.

Employee Exit Checklist

Flexible Work Schedule Request and Guidelines

Staff Employee Grievance Form

Advanced Sick Leave Request and Repayment Agreement

Application for Reduced Teaching for New Faculty Parents

Certification of Health Care Provider for Employee's Serious Health Condition (FMLA-WH380E)

Certification of Health Care Provider for Family Member's Serious Health Condition (FMLA-WH380F)

Certification of Qualifying Exigency for Military Family Leave

Leave Request Form

Leave Donation Request

Leave Pool Transfer Program.

Request for Paid Parental Leave

(DocuSign only) Request for Paid Parental Leave - please refer to College's PPL FAQs and policy for questions.

Request for Leave Transfer

Leave Pool Transfer Program.

SCSEA Application

W4 Form (federal)

W4 Form (state)

Direct Deposit Form

For the protection of our employees, this form must be delivered to Human Resources in person, by the person requesting the change.  ID will be required before changes are made.

How to Complete the Form and Frequently Asked Questions

Deferred Compensation Policy and Form

9/12 month payment election form-IRS Code 409A

Frequently Asked Questions

Form 8843 Instruction

Resident v. Non-Resident

FICA Exemption

Non-Immigrant Forms and Explanations.

Name/Address Change

Personal Data Sheet

Employee Statement of Injury 

Mileage Reimbursement

Supervisor Statement of Injury

Witness Statement of Injury