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Home » About Albion » Administrative Divisions » Finance and Administration » Offices and Programs » Human Resources » For Employees » Forms
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Forms

Below is a list of forms to be used by employees to process varied employee personnel and benefit needs. In some cases forms are provided under both MS Word/ MS Excel and PDF. The majority of PDF format forms are form-fill meaning you can complete the form electronically before printing. The Word form is provided so you can save an electronic copy for your records.

Please contact the Human Resources office you can't find the appropriate form.

Address/Phone/Emergency Contact Form (online form)

Benefits

Health Insurance Enrollment/Change Form (open enrollment is in May)

Health Insurance Opt Out Waiver

Medco By Mail Order form (Rx)

VISION Insurance Enrollment/Change Form (open enrollment is in May)

Direct Deposit

FMLA and other Medical or Personal Leaves

Birth/Adoption Leave Request Form

Medical Leave Request Form

Leave to Care For Medical Need of Family Member Request Form

Military Leave Request Form

FSA - Flexible Spending Arrangement

2012 Flex Spending Account Enrollment Form (open enrollment period is in November)

Reimbursement Forms (no longer a combined daycare and medical form)

Medical Reimbursement Form

Day Care Reimbursement Form

Tax Withholding Forms

Federal Form W4

State Form W4

Albion Form W4

Workplace Injury (Please inform HR the day of injury/incident)

Work Injury Report Form

About Albion

The Albion Advantage. It's the liberal arts. It's career readiness. It's providing you the knowledge, skills, and experiences you'll need to succeed in college, in your career, and in your life.

611 E. Porter St., Albion, Michigan 49224
517/629-1000

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