Forms

Note: All Virginia Tech employees with a Virginia Tech (@vt.edu) email address have access to the forms provided by Human Resources. If you are an employee, and receive an error when trying to access/download a form, please make sure you are logged in to google with your Virginia Tech email address.

Use the list and search functions to navigate Human Resources forms. The following sites contain additional forms:

Controller and Payroll
Faculty (for T&R, Research, and A/P faculty)
Parking

#	Name	Description	Category
P111	Voluntary 403(b) Retirement Contribution Election	Voluntary 403(b) retirement contribution election. Actions: Start, Change or Stop.	Benefits
P142	Notice of Improvement Needed Unsatisfactory Performance	Employee Notice of Unsatisfactory Performance and Improvement Needed Form.	Employee Relations
P151	Panel Physician Selection	Acknowledgement of employee review of panel physicians selection.	Benefits
P152	Selective Service Registration Questionnaire	Selective service registration questionnaire (males only)	General
P86	Non-paid Affiliation Appointment	Non-paid affiliation appointment form.	Employee Administration
	Counseling Memorandum on Performance	Sample performance counseling memorandum form.	Employee Relations
	Counseling Memorandum on Behavior	Sample behavioral counseling memorandum form.	Employee Relations
	Letter Placing an Employee on Leave for Administrative/Civil and Work-Related Leave Pending Internal Investigation	Sample letter placing an employee on leave for administrative/civil and work-related leave pending internal investigation.	Employee Relations
129-01-004	Written Notice	Important information concerning issuing a written notice	Employee Relations
	Resignation Acceptance Letter	Resignation acceptance letter for Virginia Tech employees.	Employee Relations
	Due Process Letter (After Investigation)	Sample Due Process letter to be used when employee has been on pre-disciplinary leave pending investigation.	Employee Relations
	Due Process Letter (No Investigation)	Sample Due Process letter to be used when there is no pending investigation.	Employee Relations
	Letter Terminating Wage Employment	Sample letter terminating wage employment.	Employee Relations
	Letter Terminating Probationary Employment	Sample letter terminating probationary employment.	Employee Relations
	Pre-Disciplinary Leave Letter Pending Standards of Conduct Investigation	Sample letter placing an employee on pre-disciplinary leave pending standards of conduct investigation.	Employee Relations
P188	Memorandum of Agreement and Promissory Note For Tuition Credits	Memorandum of Agreement and Promissory Note for Tuition Credits in Accordance with Tuition Assistance and Reimbursement for Salaried Employees.	Benefits
17834	Consent To Life Insurance - New York Life Optional Life Insurance	Consent to New York Life Insurance Company - Spouse/Domestic Partner/Parent/Grandparent	Benefits
	Consent For Prospective Supervisor to Review Personnel File	Consent form for employee personnel file to be reviewed by authorized person or agency.	Employee Administration
VRS-2	Designation of Beneficiary	Designation of beneficiary form through the Virginia Retirement System.	Benefits
P3A	P3A – Staff and Faculty Actions or Change of Status	Report of staff and faculty actions or change of status.	Employee Administration
P4B	Request for Employee Leave	Request for employee leave form. Should be submitted as soon as leave decisions are made.	Human Resources
P6A	Leave Sharing Donor Form	Leave sharing donor form.	Leave
P12B	Change of Name, Address or Social Security Number (SSN)	Form used by employees to change name, address or SSN.	Employee Administration
P14A	Part Time Temporary Faculty Appointment Authorization For Payment	Provides wage compensation for part-time temporary faculty-level services in instruction, research, outreach or administration.	Employee Administration
P94	Restricted Staff Apointment Acknowledgement	Appointment to a restricted position (classified staff or university staff)	Employee Administration
P99	Request for Human Resources Records	Request form to review or receive copies of official personnel records from Human Resources.	Employee Administration
P108	Emergency Hire Extension	Emergency hire form for non-student wage employment.	Employee Administration
P112	Technical Correction Form	Request to change an employee work profile P112 technical correction. Internal use only.	Employee Administration
P120	Personnel Signature Authorization	Human Resources Signature Authorization from the Dean or Vice President of a specified department.	Employee Administration
P125	Probationary Progress Review	Employee Probationary Progress Review Form	Employee Relations
P146	Request For Extension of Probationary Period	Request form for an extension of probationary period, not exceeded 18 months.	Employee Relations
P153	Request to Establish Employee Award or Recognition Program	Request for to establish employee award or recognition programs. Brief description, participating departments, and funding source.	Compensation
P154	Employee Recognition Award Payment and Leave Form	Employee Recognition Aware Payment and Leave Form (Prior program approval required)	Compensation
	Return To Work Release	Return to work release form based on evaluation.	Benefits
	Shelter Leave / One Time Deferral 403(b)	Sheltered leave/additional pay defferal form to modify salary as indicated.	Benefits
SS	Summer Session Teaching Appointments	This form is used for summer session 1 and 2 teaching appointments.	Employee Administration
	Summer Sessions Research Appointments	Form used for the summer session research appointments only.	Employee Administration
	Staff Checklist	New staff hiring checklist	Recruiting
	Volunteer Sample Letter	Volunteer services sample letter including summary of duties and responsibilities.	Policy and Compliance
	Paid Parental Leave Eligibility	Paid Parental Leave Eligibility Application Form	Leave
	FMLA - Certification of Health Care for Employee’s Serious Health Condition	Family and Medical Leave Act of 1993 - Employee Packet	Leave
	FMLA - Certification of Health Care for Family Member's Serious Health Condition	Family and Medical Leave Act of 1993 - Employee Packet	Human Resources
	Conviction Check Request	Request conviction and other pre-employment checks.	Policy and Compliance
P6	Leave Sharing Recipient Form	Leave sharing recipient form - reason for leave, estimated length of absence, and rights.	Leave
P14	Sample Letter for Part-Time Temporary Wage Appointment	Sample letter for part-time temporary wage appointment. Some information is instructional and you need to put in the appropriate information.	Employee Administration
A10385	State Active Enrollment	State health benefits program enrollment form for employees.	Benefits
F52833	Securian Enrollment Form	Enrollment application for VRS optional group life insurance with Securian Financial.	Benefits
F53411	Securian Change Form		Benefits
F52749	Securian Evidence of Insurability		Benefits
F52729	VRS Certificate of Life Insurance		Benefits
P12W	Wage Employee Appointment Record	Wage employee appointment record form.	Employee Administration
	Reappointment Administrative Professional FT Academic Year Regular	Re-appointment terms for AP faculty in full-time academic year regular roles.	Recruiting
	Reappointment Administrative Professional FT Academic Year Restricted	Re-appointment terms for AP faculty in full-time academic year restricted roles.	Recruiting
	Reappointment Administrative Professional FT Calendar Year Regular	Re-appointment terms for AP faculty in full-time calendar year regular roles.	Recruiting
	Reappointment Administrative Professional FT Calendar Year Restricted	Re-appointment terms for AP faculty in full-time calendar year restricted roles.	Recruiting
	Reappointment Administrative Professional PT Calendar Year Regular	Re-appointment terms for AP faculty in part-time calendar year regular roles.	Recruiting
	Reappointment Administrative Professional PT Calendar Year Restricted	Re-appointment terms for AP faculty in part-time calendar year restricted roles.	Recruiting
	Reappointment Research FT Academic Year Restricted	Re-appointment terms for research faculty in full-time academic year restricted roles.	Recruiting
	Reappointment Research FT Calendar Year Restricted	Re-appointment terms for research faculty in full-time calendar year restricted roles.	Recruiting
	Reappointment Research PT Academic Year Restricted	Re-appointment terms for research faculty in part-time academic year restricted roles.	Recruiting
	Reappointment Research PT Calendar Year Restricted	Re-appointment terms for research faculty in part-time calendar year restricted roles.	Recruiting
	Reappointment Teaching & Research FT Academic Year Regular One Year	Re-appointment terms for one year for teaching and research faculty in full-time academic year regular roles.	Recruiting
	Reappointment Teaching & Research FT Calendar Year Regular One Year	Re-appointment terms for one year for teaching and research faculty in full-time calendar year regular roles.	Recruiting
	Reappointment Teaching & Research FT Academic Year Restricted	Re-appointment terms for teaching and research faculty in full-time academic year restricted roles.	Recruiting
	Reappointment Teaching & Research FT Calendar Year Restricted	Re-appointment terms for teaching and research faculty in full-time calendar year restricted roles.	Recruiting
	Reappointment Teaching & Research PT Academic Year Restricted	Re-appointment terms for teaching and research faculty in part-time academic year restricted roles.	Recruiting
	Reappointment Teaching & Research PT Calendar Year Restricted	Re-appointment terms for teaching and research faculty in part-time calendar year restricted roles.	Recruiting
P36	Request for Additional/Outside Employment for Classified or University Staff	This form should be used by classified and university staff members to seek advance approval for additional employment outside of Virginia Tech in accordance with Policy 4070.	Employee Administration
P126	Memorandum of Agreement for Educational Aid Reimbursement	This memorandum of agreement needs to be completed per University Policy 4800: Tuition Assistance and Reimbursement Program for Salaried Employees	Benefits
	Telework/Alternate work schedule agreements and Tuition waiver requests	Online form used to apply for telework or alternative work schedule agreements and to create tuition waiver requests	Benefits
	Recruitment Consultation Request	Complete this form to start recruitment initiation with the HR Recruitment team. Please enter information as thoroughly as possible.	Recruiting
	Orientation Scheduler	Form for self-scheduling an orientation session	Orientation
	Employee Telework/Remote Work Self-Assessment Questionnaire	Employees should complete this form to determine if their role is suitable for telework/remote work.	Benefits
	Manager Telework/Remote Work Suitability Questionnaire	Managers should complete this form to determine if a role and an employee are suitable for telework/remote work.	Benefits
VRS65	Faculty Election of Retirement Plan		Benefits
	Pool Certification Template	This form should be used to certify a faculty pool for a position prior to moving to an job offer.	Recruiting
	Election to Change Optional Retirement Plan Provider	Change Retirement Plan Provider	Benefits
	Prior Leave Accrual Transfer	Prior Leave Accrual Transfer form	Leave
N/A	HR Contacts	HR representatives and recruiting contacts for senior management areas.	Strategic Initiatives
N/A	Request to Convert from Classified to University Staff	This form needs to be completed by the employee and HR rep when an employee converts from classified to university staff.	Compensation
	Supervisor Bulk ePAF Update	Bulk supervisor update form	Employee Administration
	Faculty Forms	Forms specific to T&R, Research, A/P faculty are available on the Faculty Affairs site.	Provost Office
	Controller and Payroll Forms	Controller and Payroll Forms are available on the Controller website.	Controller and Payroll
	Parking Forms	Parking forms are available on the Transportation Services website.	Transportation and Parking

North End Center, Suite 2300 (0318)
300 Turner Street NW
Blacksburg, VA 24061

Hours 8 a.m.-5 p.m.
Phone 540-231-9331
Fax 540-231-3830
Email hrservicecenter@vt.edu
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