INSTITUTIONAL FORMS REPOSITORY PAGE
This institutional forms repository is organized according users (Faculty/Staff; Students; or Public). The Faculty & Staff portion of the page is organized alphabetically according to departments. Within an office the forms are organized alphabetically by form name. The Student section of the page is organized so that (hopefully) the more commonly used forms for students are listed first.
The forms available are in a variety of program types. If the document type is specified as a 'Form', then the link takes you to a document that is electronically fillable, but not editable in any other way. In time, help documents will be developed to assist users with using the various form types. Eventually, we intend to develop the forms page so that the users can filter out only the forms that they might need, based on Institution, User type, Department, and even Form Name. *|PDF Form |Word Form |Drupal Form |HTML Form |Excel Form |Infopath
If you have any forms to add or update, please contact the webmaster.
To skip to a specific section, click on the name.
**To open the PDF forms, you must have Adobe Reader
| FACULTY & STAFF FORMS |
| Academic Affairs (aa) (In most cases there are different forms for PCTC and FSU) |
| Form Name | File Name/Type | Description/Notes | Contact | Updated |
| Application for Promotion Directions |Word Doc |
Cover Sheet |PDF Form | print and sign | Judy Biafore | 11/08 |
| Peer Evaluation |Word Form | print and sign | |||
| Chair Evaluation |Word Form | print and sign | |||
| Application for Tenure Directions |Word Doc |
Cover Sheet |PDF Form | print and sign | Judy Biafore | 11/08 |
| Peer Evaluation |Word Form | print and sign | |||
| Chair Evaluation |Word Form | print and sign | |||
| Application for Promotion - Senior Level Directions |Word Doc |
Cover Sheet |PDF Form | print and sign | Judy Biafore | 11/08 |
| Evaluation for Probationary Faculty - 1st & 2nd Year Directions |Word Doc |
Self-Evaluation |Word Form | print and sign | Judy Biafore | 9/08 |
| Peer Evaluation |Word Form | print and sign | |||
| Chair Evaluation |Word Form | print and sign | |||
| Sabbatical Application | Application |Word Form | print and sign | Judy Biafore | 5/08 |
| Agreement |PDF Form | print, sign, & notarize | |||
| Dean and Provost Evaluation Tool |
Evaluation Tool|Word Doc | print and sign | Judy Biafore | 5/08 |
| Dean/Chair Evaluation Directions |Word Doc |
Dean Evaluation |PDF Form | Judy Biafore | 5/08 | |
| Curriculum Proposal |
Curriculum Proposal |Word Doc |
instructions | Christina Lavorata | 3/10 |
| Online Course Peer Evaluation Form |
Online Course Peer Evaluation Form |Word Doc |
print and sign | Roxann Humbert |
11/08 |
| FSU Degree Definitions & Procedure for Requesting Exceptions |
Degree Definitions |PDF |
procedures |
Christina Lavorata | 11/08 |
| Degree Exception Procedures |Word Doc | ||||
Program Review Form - Fine Arts |Word Doc (contact: Peter Lach)
Cap and Gown Request Form |Drupal Form (contact: Peggy Frum)
Course Book Information Request |HTML (contact: Peggy Frum)
Course Pack Order Form |PDF (contact: Peggy Frum)
Publisher Information Form | PDF (contact: Peggy Frum)
| Business Office (bo) |
BO - Accounts Payable
Employee Reimbursement Request: WVSAO ER1 |PDF (contact: Holly Fluharty)
Receiving Report: WVSAO RR1 |PDF (contact: Holly Fluharty)
Tax Exempt Certificate: SSTGB Form F0003 |PDF (contact: Holly Fluharty)
Transfer of Expense Request |Word Doc (contact: Holly Fluharty)
Vendor's Invoice |Word Doc (contact: Holly Fluharty)
Wireless Device Stipend Agreement |Word Doc (contact: Holly Fluharty)
BO - Procurement
Account Codes – FY 2011 PDF
Determination of Independent Contractor Worksheet |Word Doc (contact: Monica Cochran)
Independent Contractor Declaration |Word Doc (contact: Monica Cochran)
Purchase Change Request |Word Doc (contact: Monica Cochran)
Purchasing Affidavit |PDF (contact: Monica Cochran)
Request for Taxpayer ID # and Certification (W-9 Form) |PDF Form (contact: Monica Cochran)
Request for Temporary Space: WV-15 |PDF (contact: Monica Cochran)
Requisition |PDF Form (contact: Monica Cochran)
Requisition for Space: WV-14 |PDF (contact: Monica Cochran)
Single-Sole Source Justification |Word Doc (contact: Monica Cochran)
Telephone Quotation Form |Excel (contact: Monica Cochran)
W-8BEN: Certificate of Foreign Status...for US Tax Withholding (Instructions) |PDF & W-8BEN Form |PDF Form (contact: Monica Cochran)
WV-1: WV Vendor Registration & Disclosure Statement |PDF (contact: M. Cochran) *over $1,000
WV-1A: WV Vendor Registration & Disclosure Statement |PDF Form (contact: Monica Cochran) *under $1,000
WV-48: FSU Vendor Agreement |PDF Form (contact: Monica Cochran)
WV-96: WV Vendor Agreement Addendum |PDF (contact: Monica Cochran)
BO - Purchasing Cards
Hospitality Documentation |Excel (contact: Becky Miller)
Hospitality Guidelines |PDF (contact: Becky Miller)
P-Card Application |PDF (contact: Becky Miller)
P-Card Cardholder Agreement |PDF (contact: Becky Miller)
P-Card Dispute Form |PDF (contact: Becky Miller)
P-Card Missing Receipt Form |Word Doc (contact: Becky Miller
P-Card Purchase Justification |Word Doc (contact: Becky Miller)
P-Card Web-based Training Instructions |HTML (contact: Becky Miller)
P-Card Worksheet Fax Form |Excel (contact: Becky Miller)
BO - Travel
Credit Card Hotel Authorization Form |Word Doc (contact: Jolie Carpenter)
Exxon Card Affidavit |PDF (contact: Jolie Carpenter)
Travel Settlement/Summary Form (contact: Jolie Carpenter)
Center for Teaching Excellence (cte)
Adjunct Faculty Information Form |PDF Form
| Copy Center (cc) |
Auditron Reporting Form |Excel (contact: Monica Cochran)
Copy Center Request Form |Infopath Form (contact: Georgeann Cain) *Note: Please make sure that when you fill out this form, that you fill it out COMPLETELY. Please specify whether the copies should be singe- or double-sided and whether or not the document needs to be stapled.
| Facilities and Capital Projects (Physical Plant) (pp) |
Custodial Evaluation Form
Key Request Form |Infopath Form (contact: Stephanie Slaubaugh) *Note: Restricted submission
Physical Plant Work Order |Infopath Form (contact: Stephanie Slaubaugh) *Note: Restricted submission
Supply Order Form |Excel (contact: Lenora Montgomery) *Physical Plant Purchasing/Shipping/Receiving
| Faculty & Staff Awards and Foundation Grants (fsaw) |
Classified Employee of the Year Nomination Form |Word Doc
Faculty Development Committee (Center for Teaching Excellence)
Faculty Recognition Award |PDF (contact: Sarah Dodson)
Foundation Fellow Award |PDF and Rubric |PDF (contact: Matt Hokom)
Foundation Grants Program |PDF (contact: Mary Beth Angeline or Brian Floyd)
Great Teachers' Seminar |PDF (contact: Beth Larouere or Nancy McClure)
Regional Service and Engagement/Economic Development (RSEED) Grant |PDF (contact: Brian Floyd)
Teaching Professor Conference Awards |PDF and Rubric |PDF (contact: Nancy McClure )
Teaching Awards Rubric |PDF *Note: applies to the following 4 awards
Harold and Roselyn Williamson Straight Award |PDF (contact: Troy Snyder)
Outstanding Adjunct Award |PDF (contact: Charley Hively)
Paul E. Edwards Award for Teaching Excellence |PDF (contact: Anna Romano)
William A. Boram Award for Teaching Excellence |PDF (contact: Roxann Humbert or Nancy McClure)
| Fine Arts (fa) |
Reservation Form for Wallman Hall |Word Doc (contact: Debby Rogers)
| Human Resources Office (hr) |
HR - Classification/Compensation
Adjunct Rates |PDF
Faculty CIP code description |Excel
PIQ Summary by Job Family |PDF (contact: Maria Marshall)
Position Information Questionnaire |PDF
HR - Employment Forms
Monthly Work Record (contact: Cinda Lu Ewing) *Note: for Non-Exempt, Classified Employees
Payroll Forms |PDF (contact: Cinda Lu Ewing) *Includes: W-4 Forms, Resident/Non-Resident WV Withholding Forms, I-9 Forms, Direct Deposit Form, WV Higher Ed. Retirement Programs
Temporary Appointment Fringe Benefits Calculation forms: (Full Time) |Excel (Part Time) |Excel (contact: Colleen Roberts)
Temporary Appointment For Special Program Online Instructions |PDF (contact: Maria Marshall)
Employee Fringe Benefits Calculation forms (Full Time) / Excel (Part Time) / Excel (contact: Colleen Roberts)
Time Sheet - Student/Hourly Employees |PDF (contact: Sherry Baldwin) *Note: student time sheet must be printed on BLUE paper
Time Sheet and Pay Schedule (contact: Sherry Baldwin)
HR - Departmental
Authorization for Unused Annual and Sick Leave Form
Name Address Change Form
Occupational Injury/Illness Report
Workers' Compensation or Sick Leave Benefits Election of Option Form
HR - Interview Process
Confidential Interview Evaluation Form |PDF
Pre-employment Inquiry Guide |PDF
HR - Leave of Absence
Catastrophic Leave Donation Request |PDF
Leave of Absence Options |PDF
HR - Miscellaneous Forms
Optional Employee Election To Reduce F.T.E. |PDF
HR – Separation from Employment
Voluntary Phased Retirement Plan Form | PDF (Please meet with HR as a first step in this process)
HR - Student Employees
Student Employment Information Sheet |PDF (contact: Ann Lester)
Student On-Line Pay Information |PDF
| Information Technology (it) |
IT - Administrative Systems
Project Request Form |Excel
Banner Access Request
Exit Form
IT - External Applications
Request to Migrate Section Template
Request to Archive Section Template |HTML
IT - Networks, Security and Servers
Expense Transfer
IT - Project Management Office
Project Charter |Word Doc
Project Scope Definition |Word Doc
Project Baseline Schedule |Word Doc
Project Status Report |Word Doc
IT - Solution Center
Computer Hardware-Software Justification |Word Doc (contact: Kelly Pryor)
Equipment Loan Form |Word Doc
Expense Transfer
IT Purchase Authorization Form |Word Doc (contact: Kelly Pryor)
IT Purchase Justification |Word Doc (contact: Kelly Pryor)
Software Purchase
IT Student Organization Equipment and Material Loan |Word Doc (contact: Kelly Pryor)
IT Work Order
| Leadership Marion (lm) |
Brochure |PDF (contact: Budd Sapp)
Application |PDF (contact: Budd Sapp)
| Learning Technologies Center (ltc) |
Creating the Course Syllabus; WebCT Vista 3.0 Training Manual
Creating WebDAV Folders in Windows
Importing WebCT CE Content into Vista
Request to Migrate Section Template
Request to Archive Section Template |HTML
Respondus 3.5 - Installation Instructions |HTML
Vista 3.0 Designer and Instructor Reference Manual |PDF
| Libraries (lib) |
Fairmont State Library Gift Form |PDF (contact: Cindy Knight)
Government Resources |HTML (contact: Cindy Knight)
Library Instruction Evaluation Form |HTML (contact: Cindy Knight)
Library Instruction Request Form (On and Off-Campus) |HTML (contact: Cindy Knight)
| Miscellaneous |
Permit to use alcoholic beverages on campus |PDF
| Public Relations and Marketing (pr) |
Spotlight request/update forms
Submit a story idea?
| Sponsored Grants Accounting (rs) |
Final Grant Proposal Certification Form |Word Doc (contact: Sandy Shriver)
Grant Budget Transfer of Funds Request |Excel Form (contact: Sandy Shriver)
Grant Proposal Pre-Certification Form |Word Doc (contact: Sandy Shriver)
Request for Grant Budget Creation |Excel Form (contact: Sandy Shriver)
Institutional Review Board “Human subjects” application |Word Doc (contact: Sandy Shriver)
Informed Consent Form |Word Doc (contact: Sandy Shriver)
| Web & Graphic Communications (wgc) |
Graphics Work Order |PDF (contact: Lynne Conrad)
Photo Release Form |PDF (contact: Lynne Conrad)
FSU One Time Exemption Licensing Form |PDF (contact: Lynne Conrad)
One Time Photo Use Form |PDF Form (contact: Lynne Conrad)
FSU Trademark Usage Request |PDF (contact: Lynne Conrad)
| STUDENT FORMS |
| Admissions (adm) |
Campus Visit Information (Schedule Individual or Group Tours) |HTML (contact: Steve Leadman)
Graduate Application for Admission |PDF (contact: Phil Mason)
Join Our Mailing List |HTML
Online Undergraduate Application for Admission |HTML (contact: Steve Leadman)
Undergraduate Application for Admission & Residence Hall Lease |PDF (contact: Steve Leadman)
| Financial Aid (fia) |
Epay: Online Payment System |HTML
2009-10 FAFSA Verification Worksheet Dependent or Independent |PDF
Free Application for Federal Student Aid (FAFSA) |HTML
PLUS Loan Application |PDF
Standards of Satisfactory Academic Progress |PDF
SAP Appeal Form for FSU students |PDF for PCTC students |PDF
Scholarships
FSU & PC&TC Scholarship Application |PDF
Application for PROMISE Scholarships & the WV Higher Education Grant |HTML
Full-Ride Scholarship |PDF *Note: for PROMISE Scholarship recipients
Multicultural Affairs:
Hunt-Arnold Scholarship Application |Word Doc (contact: Kat Stevens) *Note: Not currently accepting applications - all awards have currently been disbursed.
| Registrar's Office (ro) |
Change of Major (contact: Enrollment Services)
Permission to Add/Overide |PDF (contact: Enrollment Services)
Permission to Take Extra Hours | PDF (contact: Provost Office)
Prerequisite and Co-requisite Change Form | PDF Form (contact: Provost Office)
Transcript Request Form |PDF Form (contact: Enrollment Services)
Practice Schedule Form |PDF Form (contact: Evie Brantmayer)
Student Registration Form |PDF Form (contact: Evie Brantmayer)
| Graduate Studies - Student Resources and Forms (gs) |
Graduate Assistantship Application |PDF (contact: LeaAnn Valentine)
Concurrent Enrollment Application Form |PDF (contact: LeaAnn Valentine)
Degree Plan |PDF (contact: LeaAnn Valentine)
Graduate Faculty Membership And Application Form |PDF (contact: LeaAnn Valentine)
Graduation Checklist |PDF (contact: LeaAnn Valentine)
Request For Transfer Of Credit |PDF (contact: LeaAnn Valentine)
Special Course Approval Form |PDF (contact: LeaAnn Valentine)
Student Checklist |PDF (contact: LeaAnn Valentine)
| Fairmont State University (fsu) |
College of Science and Technology
Adjunct Faculty spotlight form |HTML Form
Alumni spotlight form |HTML Form
Emeritus faculty spotlight form |HTML Form
Science, Engineering and Energy Fair |HTML Form (contact: Michelle Poland)
Student spotlight form |HTML Form
School of Education
Application for Admission |Word Doc
Declaration of Intent |Word Doc
PRAXIS |HTML
Clinical Experience I: Placement Form |PDF; Assessment Form |PDF (contact: Barbara Owens)
Clinical Experience II: Placement Form |PDF; Assessment Form |PDF (contact: Barbara Owens)
Clinical Experience III: Assessment Form |PDF (contact: Barbara Owens)
Clinical Experience I - II Student Time Log |PDF
Clinical Experience Assessment Rubric Instructions |PDF
Clinical Experience Teacher Candidate Release Form |PDF
School of Nursing & Allied Health Admin
A.A.S. Nursing Program Application for Admission |PDF
FSU ADN Student Handbook |PDF (contact: Heidi Mahaney)
FSU Nursing Candidate Selection Score Sheet |PDF
| Pierpont Community & Technical College (pc) |
PCTC Curriculum Proposal Form |Word Doc
Culinary Arts Application | PDF
Homeland Security Application | PDF
Pastry & Baking Arts Application | PDF
School of Health Careers
School of Health Careers General Application *Note: Students must be accepted into the School of Health Careers before being accepted into a specific program of study. This is in addition to the PC&TC application.
Health Information Technology Application (HIT) |PDF (contact: Rosemarie Romesburg)
Medical Laboratory Technology Application (MLT) |PDF (contact: Rosemarie Romesburg)
Physical Therapist Assistant Application (PTA) |PDF (contact: Rosemarie Romesburg)
Radiologic Technology Application (Rad Tech) |PDF (contact: Rosemarie Romesburg)
Respiratory Care Application (Resp Care) |PDF (contact: Rosemarie Romesburg)
Veterinary Technology Application (Vet Tech) |PDF (contact: Rosemarie Romesburg)
| Workforce Development/Off-Campus Programs (cwe) |
Center for Workforce Education-Registration
Apprentice Underground Miner "Red Hat" Course |PDF Online Registration |HTML (contact: Paul Schreffler)
Certified Procedural Coding Program |PDF (contact: Paul Schreffler)
Certified Protection Officer (CPO) Course |PDF (contact: Paul Schreffler)
Grant Writing Course |PDF (contact: Paul Schreffler)
NHLA Lumber Grading Program |PDF (contact: Paul Schreffler)
Oil & Gas Drilling - Floorhand Training Program |PDF (contact: Paul Schreffler)
Online Medical Transcription Training Program |PDF (contact: Paul Schreffler)
Center for Workforce Education-Financial Aid
WV Higher Education Adult Part-Time Student (HEAPS) Grant Program:
HEAPS Workforce Development Financial Aid Application |PDF (contact: Paul Schreffler)
Workforce Development Financial Aid Application FAQs |PDF (contact: Paul Schreffler)
| Student Affairs - Campus Life (sl) |
Residence Life (Housing)
College Park Apartments Application & Lease Agreement 2008-2009 |PDF (contact: Leticia West)
On-campus Exception Request Form |PDF Form (contact: Leticia West)
Residence Hall Application 2008-2009 |PDF (contact: Leticia West)
Special Housing Accommodation Request |Word Doc (contact: Leticia West)
| Student Affairs - Student Services (ss) |
Crisis Counseling/Student Affairs Counselor
Notice of Absence
Disability Services
Americans with Disabilities Act |HTML (contact: Andrea Pammer)
Disability Accommodation Complaint Procedures for Students |Word Doc (contact: Andrea Pammer)
Documentation of Disabilities:
Attention Deficit/Hyperactivity Disorder |Word Doc (contact: Andrea Pammer)
Blindness And Low Vision |Word Doc (contact: Andrea Pammer)
Deafness And Hard Of Hearing |Word Doc (contact: Andrea Pammer)
Learning Disabilities |Word Doc (contact: Andrea Pammer)
Physical/Medical Disabilities |Word Doc (contact: Andrea Pammer)
Psychological/Psychiatric Disabilities |Word Doc (contact: Andrea Pammer)
Traumatic Brain Injury |Word Doc (contact: Andrea Pammer)
Electronic Format Text Book Request Form |Word Doc (contact: Andrea Pammer)
How to Qualify for Disability Services through FSU |Word Doc (contact: Andrea Pammer)
Request Form for Interpreting Services |Word Doc (contact: Andrea Pammer)
Rehabilitation Act Section 504 |HTML Section 508 |HTML(contact: Andrea Pammer)
Tutor Request Form |Word Doc (contact: Andrea Pammer)
International Students
Admissions and Scholarship Information for International Students |PDF
Health Form |PDF
Sponsor Affidavit |PDF
Transfer Eligibillty |PDF
Student Affairs - Student Activities (sa)
Alumni Relations/ Alumni Association
Alumni Volunteer Opportunities |HTML Form
Update Your Alumni Record |HTML Form
Nomination for Alumni Awards
Request for support from Alumni Association
Feaster Center Trainer
Parent Letter / Instructions for Forms Completion
Acknowlegement of Risk
Physical Form
Insurance Protocol
Athletic Competition Release
Medical Information Release
Medical History
Intramural Sports
Intramural Sport Agreement Form |PDF (contact: Tina Mascaro)
Intramural Sports Roster |PDF (contact: Tina Mascaro)
Sport Commitment Sheet |PDF (cusodian: Tina Mascaro)
| PUBLIC FORMS |
| Community Service Learning (csl) |
FSU Counts: Registration Form |Drupal Form (contact: Cathy Woodson)
FSU Reads: Pre-Registration Form |HTML Form (contact: Cathy Woodson)
Service Activity Record |Drupal Form (contact: Donna Nuzum)
| Fairmont State Foundation Giving Opportunities (fsf) |
Irrevocable Stock/Bond Power |PDF
Make a Gift Via Check Using Regular Mail |HTML Form *Note: must be printed and mailed.
Make a Gift Via Credit Card Using Regular Mail |HTML Form *Note: must be printed and mailed.
Make a Pledge |HTML Form
Make Your Gift by Credit Card |HTML Form
Update Your Fairmont State Profile |HTML Form
| Public Safety (ps) |
Anonymous Complaint
Parking Decal & Token Request |PDF
Parking Decal & Token Request |Word Doc
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