Human Resources Forms

• Benefits Forms
  • Tufts Health Plan Enrollment Form [dynamic form]
  • Delta Dental Enrollment Form [dynamic form]
  • EyeMed Vision Enrollment Form [dynamic form] 
  • 2020 Flexible Spending Account Enrollment Form [dynamic form] 
  • Health Insurance Waiver Form [dynamic form] 
  • 2020 Lesley Retirement Plan - Salary Deferral Agreement - Core Employees [dynamic form]
  • 2020 Lesley Retirement Plan - Salary Deferral Agreement - Adjunct Faculty and Core less than .5 FTE [dynamic form]
  • 2020 Health Savings Account Enrollment Form [dynamic form]
  • Unum Supplemental Life Insurance Enrollment Application [pdf] 
  • Unum Life Insurance Designation of Beneficiary Form [pdf]
  • Application for Tuition Remission [dynamic form] 
  • Tuition Remission Eligibility Certification [dynamic form] 
  • Employee MBTA Parking Reimbursement Form [doc] 
  • Lesley Retirement Plan - Salary Deferral Agreement - Unused Accrued Vacation Leave [doc]
  • Phased Bridge Retirement Application Form (Faculty) [doc]
• Compensation Forms
  • Salary Grade Schedule July 1, 2018 [pdf] 
  • Position Justification [pdf]
  • Position Justification [doc]
  • Position Justification (Temporary Assignments) [doc]
• Employment Forms
  • Employee Referral Form [pdf]
• Medical Leave Forms
  • FMLA Request for Employee or Employee's Family Member [dynamic form] 
  • Certification for Serious Injury of Servicemember-Military [pdf] 
  • Certification of Qualifying Exigency-Military [pdf]
  • Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave [pdf]
  • Gift of Time Donation [pdf]
  • Gift of Time Request [pdf]
  • Certification of Healthcare Provider for an Employee [pdf]
  • Certification of Healthcare Provider for a Family Member [pdf]
• New Employee Forms
  • Tax Withholding Allowance Certificate (Form W4) 
  • Massachusetts Withholding Exemption Certificate (Form M4)
  • US Employment Eligibility Verification (Form I-9)
  • Application for Employment
  • Background Check Paperwork
  • Personal Information Sheet
  • FCRA Updated Rights
  • Summary Of Your Rights (Spanish)
  • Pregnant Workers Fairness Act
  • Marketplace Notice
• Performance Forms
  • FY18 Interim Performance Feedback Review Form (grades 7-24) [doc]
  • FY18 Interim Performance Feedback Review Form (grades 25-34) [doc]
  • FY18 Interim Performance Feedback Directions and Rating Definitions (grades 7-34) [pdf]
  • FY19 Interim Performance Feedback Review Form (grades 7-24) [doc]
  • FY19 Interim Performance Feedback Review Form (grades 25-34) [doc]
  • FY19 Interim Performance Feedback Directions and Rating Definitions (grades 7-34) [pdf]
• Training and Professional Development
  • Professional Development Support Application [dynamic form]