Forms
BENEFIT FORMS
- Benefits Enrollment Form
- Medical - CIGNA Out of Network Claim Form
- Medical - CIGNA Mail Order Drug Form
- Dental - Out of Network Claim Form
- Dependent Tuition Program Tuition Claim Form
- Dependent Tuition Book Claim Form
- HSA Contribution Form - 2018
- HSA Contribution Form - 2019
- Vision - Cigna Eye Exam claim form
- Vision - EyeMed Out of Network Claim Form
- FSA - MERA/DepCare Claim Form
- Life Insurance - Beneficiary Change Form
- Affidavit of Domestic Partnership
- Statement of Termination of Domestic Partnership
- Neighborhood Preschool Scholarship Application
- Tuition/Educational/GLSP Assistance Application
- Wesleyan Mortgage Program Locality Map
MISCELLANEOUS FORMS - HUMAN RESOURCES
- Additional Earnings Request Form - Salaried Employees
- Additional Earnings Request Form - Hourly Employees
- Alternate Work Schedule Agreement
- Cardinal Achievement Award
- Commuter Tax Benefit Deduction
- Commuter Tax Benefit Claim
- Conference/Travel Request Form
- Exit Survey
- Leaving Wesleyan
- New Hire Checklist
- New Student Position Form
- Overtime / Other Comp Position Request
- Performance Evaluation Self-Assessment Form
- Salary/Job Upgrade Request
- Secretarial/Clerical Bargaining Unit Revised Upgrade Questionnaire
- Temporary Help Request Form
- Termination Form
- Wesleyan Annual Fund - Deduction Form
For Payroll forms, please click HERE