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Monday, May 28, 2018

Human Resources Forms

Please Note: We have moved forms more suitable only to staff/faculty to the wiki. If you don't see a form you are looking for, please check there.

2017-2018 Benefits

  • 2017-2018 Blue Sheild PPO
  • 2017-2018 Blue Shield Access Plus HMO
  • 2017-2018 Blue Shield Trio HMO
  • Beneficiary Designation/Change Card
  • Benefit Enrollment Form and Rates
  • Delta Dental - PPO Plan Summary
  • DeltaCare USA - Plan Summary
  • Enrollment Guide
  • EyeMed - Plan Summary
  • Health Advocate EAP
  • Kaiser - $20 Plan Summary
  • Kaiser - $40 Plan Summary
  • Blue Sheild Pharmacy Form
  • Vol. AD&D Brochure
  • Vol. Life Insurance

American Fidelity

  • American Fidelity - Accident Plan
  • American Fidelity - Brochure
  • American Fidelity - Cancer Plan
  • American Fidelity - Disability Plan

Leave of Absence Information

  • Employee Leave of Absence Instructions
  • Family Care - CSEA
  • Family Care - CTA
  • Leave of Absence Request Form
  • Medical Disability - CSEA
  • Pregnancy - CSEA
  • Pregnancy - CTA

Workers Compensation - Employee

  • Covered Employee Notification
  • Instructions for Injured Worker

Workers Compensation - Providers

  • FOX Occupational
  • LOMA LINDA UNIVERSITY

Workers Compensation - Supervisor

  • DWC-1
  • Employee Statement
  • Medical Authorization
  • Supervisor Instructions
  • Supervisor Statement
  • Witness Statements
  • Chancellor's Office
    • Chancellor's HSI Advisory Committee
    • Presentations and Videos
  • Quality Colleges + Quality Workforce
  • About the District
    • Mission Statement
    • Institutional Values & Planning Documents
      • District Education Planning
      • District Strategic Planning
      • Technology Planning
      • 5 Year Construction Plan
      • Long-Range Staffing Plan
      • Program Review
      • Strategic Planning Brochure
    • District Administration
    • Map Directions
    • Feedback/Suggestion Box
  • Board of Trustees
    • Trustees
    • Board Meetings
    • Agendas and Minutes
    • Policies & Procedures
    • BOT - Board to Board Committee
    • BOT - Budget Committee
    • BOT - Policy Committee
    • BOT - Student Success Committee
  • Human Resources/Jobs
    • Annual Security Report
      • SBVC
      • CHC
      • EDCT
    • Compliance Hotline
    • Employee & Labor Relations
      • Title IX
      • Employee Training and Development
        • Safety Training
        • EEO Training January 2017
        • HR Professional Development Catalog
        • Professional Development Quarterly Calendar
      • Bargaining Agreements
        • CSEA MOUs
        • CTA MOUs
      • Safety & Risk Management
        • Workers' Compensation-Injury Reporting Claim Forms
        • How to Report An Injury Claim - Nurse Advice Hotline Information
        • Air Monitoring & Assessment Information
        • General Information
          • Contact Us
          • Frequently Asked Questions
          • Safety Board Policies
          • Codes of Safe Practices
          • Safety Inspection Reports - SBVC/CHC/District-Sites
          • Safety Resources - Summary Page
          • NEW MSDSonline Safety Data Sheets (SDS)/SBCCD Chemical Inventory Website
          • SBCCD Job Hazard Assessments
        • Safety Programs
          • Illness and Injury Prevention (IIPP) Safety Program
            • San Bernardino Valley College & Crafton Hills College Injury and Illness Prevention Program - Consolidated
            • District Office Injury and Illness Prevention Program
          • Aerial Work Safety Program
            • San Bernardino Valley College & Crafton Hills College Aerial Work Platform Program - Consolidated
          • Asbestos Operations and Maintenance Program
            • Crafton Hills College Asbestos Operations and Maintenance Program
            • San Bernardino Valley College Asbestos Operations and Maintenance Program
          • Bloodborne Pathogens Safety Program
            • SBVC & CHC Bloodborne Pathogens Program - Consolidated
          • Chemical Hygiene Program
            • Crafton Hills College Chemical Hygiene Program
            • San Bernardino Valley College & Crafton Hills College - Chemical Hygiene Program
          • Fall Protection Safety Program
            • San Bernardino Valley College & Crafton Hills College Fall Protection Program - Consolidated
          • Communicable Disease Safety Program
            • Communicable Disease Safety Program
          • Confined Space Entry Safety Program - Non Permit Required
            • Confined Space Entry - Non Permit Required Safety Program
          • Fire Prevention, Life & Safety Progam
            • San Bernardino Valley College & Crafton Hills College Fire Life Safety Program - Consolidated
          • Forklift - Powered Industrial Truck Safety Program
            • San Bernardino Valley College & Crafton Hills College Forklift - Powered Industrial Truck Safety Program - Consolidated
          • Formaldehyde Program
            • Crafton Hills College Formaldehyde Program
            • San Bernardino Valley College Formaldehyde Phenol Glutaraldehyde Program
          • Hazard Communication Safety Program - Employee Right To Know
            • District Office Hazard Communication Program
            • San Bernardino Valley College & Crafton Hills College Hazard Communication Program - Consolidated
          • Hazardous Waste Management Program
            • CHC Hazardous Materials Management Program
            • SBVC Hazardous Materials Management Program
          • Hearing Conservation Safety Program
            • San Bernardino Valley & Crafton Hills College Hearing Conservation Program - Consolidated
          • Heat Illness Safety Program
            • San Bernardino Valley College & Crafton Hills College Heat Illness Prevention Program - Consolidated
          • Lockout/Tagout (LOTO) Safety Program
            • San Bernardino Valley College & Crafton Hills College Lockout/Tagout Program - Consolidated
          • Respiratory Protection Program
            • San Bernardino Valley College & Crafton Hills College - Respiratory Protection Program
            • Crafton Hills Respiratory Protection Program
          • Sewer Management Program - SBVC/CHC - 2016
            • SBVC & CHC Sewer Management Plan 2016
          • Spill Prevention Control and Countermeasure Program
            • CHC Spill Prevention Control and Countermeasure Program
            • SBVC Spill Prevention Control and Countermeasure Program
          • Utility Safety Safety Program
            • San Bernardino Valley College & Crafton Hills College Utility Cart Safety Program - Consolidated
        • Safety Training
          • UL Pure Safety Online Training Database - SBCCD Full-Time Employees
          • Keenan Safe Colleges Online Safety Training Database - SBCCD Part-Time Employees
          • Videos
        • Safety Committees
          • Crafton Hills College Safety Committee
          • San Bernardino Valley College Safety Committee
          • District Sites Safety Committee - District Admin. Offices, ATTC/PDC & TESS
          • District-Wide Safety Committee
        • Forms
          • Hazard Reporting
          • Ergonomic Evaluation Request
        • Resources/Documents/Links
        • Safety Flash Memos
        • Safety Newsletters
        • Emergency Preparedness Program & Information
          • 8th Street - Annex - Emergency Evacuation Assembly Area Map
          • Alternative Text Production Center (ATPC) - Emergency Flip Chart - 2016
          • ATTC Applied Technology Training Center - Emergency Evacuation Assembly Area Map
          • Blackboard Connect - Personal Information Update Reference Card
          • CHC - Emergency Evacuation Assembly Area Map - Revised October 2013
          • CHC - Emergency Flip Chart - Revised 2016
          • CHC 2012 Building Captain List - Revised October 2013
          • District 2013 Offices-Sites Building Monitor List - Revised October 2013
          • District-PDC Administration Offices - Emergency Evacuation Assembly Area Map
          • District Emergency Preparedness Program - August 2014
          • Redlands/Annex - Emergency Flip Chart - 2016
          • SBCCD District Offices - Admin. Offices-ATTC-PDC - Emergency Flip Chart - 2016
          • SBCCD Hazardous Mitigation Plan
          • SBVC - Emergency Evacuation Assembly Area Map - Revised October 2013
          • SBVC - Emergency Flip Chart - Revised 2016
          • SBVC 2013 Building Captain List - Revised October 2013
          • SBVC Campus AED Locations - Updated 12-2013
          • Deleting Subscribers/Unsubscribing
          • Sending an Alert
          • Evacuation With Disabilities
      • Unlawful Discrimination
    • Equal Employment Opportunity Plan
    • Newsletters
    • Employment Opportunities
    • ADP
    • Benefit Information
    • Health Care Reform
      • New Health Insurance Marketplace Coverage Notice
      • FAQs
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    • Job Descriptions
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    • FAQs-HR
    • Staff Directory
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  • SBCCD Research, Planning & Institutional Effectiveness
    • Research Reviews
    • Enterprise Data Cubes
    • Insitutional Effectiveness and Planning
      • Districtwide Institutional Effectiveness Committee
      • IEPI
        • SBCCD IEPI QEIs
      • KPI Dashboard
      • 2015-2016 Facilities and Educational Master Planning Information
        • Documents Provided by Planning Consultants
      • Planning Documents
      • SBCCD QEIs
    • Presentations
    • Research Reports and Briefs
    • SBCCD Services Planning and Program Review
      • District Services Planning and Program Review Committee
      • District PPR Archive
  • Facilities Planning and Construction
    • Prequalification/UCCAP
    • Construction Bid Opportunities
    • Citizens' Bond Oversight Committee
      • Meeting Agendas/Minutes
    • Reports to the Community
    • Community Benefits Agreement
    • Master Plans
    • Facilities Planning and Construction Staff
  • District Collegial Consultation Committees
  • District News & Events
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      • Latest News
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      • SBCCD in the News
      • Use of Image Statement
      • Release Form
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    • Chancellor's Chat Newsletters
    • Community Report - Doing What Matters in the Inland Empire
    • Crime Statistics
  • District Police
    • Active Shooter / Armed Intruder Safety
    • Daily Crime Log
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    • District Policies & Procedures
    • Emergency Preparedness
    • Employment
    • Informational Videos
    • Just the Facts
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    • Parking
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      • Parking FAQs
      • Purchase a Permit or Day Pass
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    • Safety Resources
    • Sexual Assault
    • Staff
    • Upcoming Events
    • Victim Assistance
    • Violence Against Women Act (VAWA)
  • District Wiki (login required)
  • District Faculty & Staff Information/Forms

© 2009 - 2018 San Bernardino Community College District
All Rights Reserved

114 South Del Rosa Drive San Bernardino, California 92408
Phone : 909.382.4000 Fax : 909.382.0116

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