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Open Enrollment 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]
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Benefits Forms
- Tufts Health Plan Enrollment Form [dynamic form]
- Delta Dental Enrollment Form [dynamic form]
- EyeMed Vision Enrollment Form [dynamic form]
- 2019 Flexible Spending Account Enrollment Form [dynamic form]
- 2019 Lesley Retirement Plan - Salary Deferral Agreement - Core Employees [dynamic form]
- 2019 Lesley Retirement Plan - Salary Deferral Agreement - Adjunct Faculty and Core less than .5 FTE [dynamic form]
- 2019 Health Savings Account Enrollment Form [dynamic form]
- 2018 Lesley Retirement Plan - Salary Deferral Agreement - Core Employees [dynamic form]
- 2018 Lesley Retirement Plan - Salary Deferral Agreement - Adjunct Faculty and Core less than .5 FTE [dynamic form]
- Lesley University Employee Waiver of Health Insurance Form - Eligible [pdf]
- Lesley University Employee Waiver of Health Insurance Form - Ineligible [pdf]
- 2018 Flexible Spending Account Enrollment Form [dynamic form]
- Cigna Life Insurance Designation of Beneficiary Form [pdf]
- Cigna Supplemental Life Insurance Enrollment Application [pdf]
- Application for Tuition Remission [dynamic form]
- Tuition Remission Eligibility Certification [dynamic form]
- Tuition Exchange Scholarship Certification Application [pdf]
- 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
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Employment Forms
- Employee Referral Form [pdf]
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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]
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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
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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]
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Training and Professional Development
- Professional Development Support Application [dynamic form]