Employee Benefit Forms
- BluesEnroll (online medical plan enrollment form)
- COBRA Election Form (PDF)
- Compensatory Time Report Form (PDF)
- Declaration of Domestic Partnership Form (PDF)
- Flexible Benefit Notice - Qualified Status Change (PDF)
- Dependent Care Flexible Spending Account
- FMLA - Family Medical Leave Act Information
- Health Care Flexible Spending Account
- Lincoln Alliance Tax Sheltered Annuity
- Payroll (Accounting Services) - Tax, Direct Deposit, Pay Calendar
- Report of Absence Form (writable PDF)
- Sick Leave Bank Assistance Request Form (PDF)
- Sick Leave Trade for Personal Leave Form (PDF)
- TIAA-CREF Tax Sheltered Annuity
- Full-time Employee and Part-time Credit Instructor Application for Tuition Reimbursement for JCCC Classes (PDF)
- Full-time Employee Application for Tuition Reimbursement for Non-JCCC Credit Classes (PDF)
- Salary Reduction Agreement Part-time Employees (PDF)
You will need Acrobat Reader to open the above PDF files.
