The purpose is to provide up to 12 weeks of job-protected, unpaid leave during any 12-month period to eligible, covered employees for the following reasons: 1) birth and care of the eligible employee's child, or placement for adoption or foster care of a child with the employee; 2) care of an immediate family member (spouse, child, parent) who has a serious health condition; or 3) care of the employee's own serious health condition. It also requires that an employee's group health benefits be maintained during the leave.
All requests for leave must be accompanied by the applicable certification to your need for leave. Refer to Family and Medical Leave for a description of each form.
All requests for leave must be made, if practical, at least 30 days prior to the date the requested leave is to begin.
The purpose of the Sick Leave Pool is to allow an eligible employee to contribute accrued sick leave to the Pool and if needed and approved, receive sick leave credit in the event that a catastrophic/emergency/life threatening illness or injury has depleted his/her personal sick leave account. A Physician’s Statement must accompany all withdrawal requests.
Request reimbursement from MedCom for the purchase of an eligible Flexible Spending Account item when your FSA card was not used.
Employees who have a qualifying event resulting in a family status change may modify their flexible spending account.
Order a three month supply of a prescribed maintenance drug through PrimeMail for the cost of a two month supply. This form may be used for either health insurance plan.
Register online to report a change of address or a change in dependent status due to a qualifying event. Form submission may be used when internet access is unavailable.
Register online to report a change of address or a change in dependent status due to a qualifying event. Form submission may be used when internet access is unavailable.
Employees may apply for supplemental life insurance for up to three times their annual salary (rounded to the nearest thousand). With the purchase of supplemental life insurance, employees may apply for a $25,000 policy on their spouse and a $10,000 policy on their eligible child(ren). All supplemental insurance applications require the completion of an EOI form.
Employees may update their beneficiary information at any time.
Compensation Forms
Position Reclassification
Please make your
request for a Comprehensive Position Questionnaire (CPQ) for
possible reclassification of your position through the Human
Resources Department by contacting Bonnie Trenary at 904.632.3196.
This form must be completed
when hiring new administrative, professional and faculty personnel. It must
be submitted to HR as part of the hiring package.
Upon meeting the criteria, this form is used to request a one step increase to your base salary upon completion of Florida State College at Jacksonville credit and/or non-credit courses.
In the event of your death while you are an employee of Florida State College at Jacksonville this form designates the disbursement of any monies that you would otherwise be entitled to receive (i.e. payroll, annual leave, sick leave etc.). You will need to list your beneficiaries in either sequential order — benefits will be paid out in the order named — or jointly — with each to receive the specified percentage you indicate.
This form is to be completed by all Administrative, Professional and Faculty employees of Florida State College at Jacksonville to attest that they will not violate Florida’s Principles of Professional Conduct for the Education Profession. The copy of the Code of Ethics should be retained by the employee for their records.
This form is to
be completed by all full-time and regular part-time employees
to identify the Financial Institution of choice for direct
deposit of payroll checks.
This form is used to designate beneficiaries for your FRS benefits in the event of your death if you elect option #1 on the EZ Retirement Plan Enrollment Form.
This form is used to designate beneficiaries for your FRS benefits in the event of your death if you elect option #2 on the EZ Retirement Plan Enrollment Form.
This
form is required under Florida Statute 876.05 of any employee
of the state of Florida “to take acknowledgments of
instruments for public record in the state . . . ”
This form is used for part-time adjuncts ONLY. All other part-time category employees should complete a Beneficiary Designation Form and Loyalty Oath Form separately.
This
form is required any time a new employee is hired or a current
employee moves to a different position, campus or under a
different budget. This form may only be filled out
by the hiring administrator.
This form is required
before a position can be advertised. Career positions are
advertised for a minimum of 15 working days and Admin/Professional/Faculty
positions are advertised for a minimum of 20 working days.
Internal Only positions are advertised for only 10 working
days.
The purpose of this form is to request the approval to advertise a full-time or regular part-time position. This form must be completed by the appropriate Cabinet member.
This form will be completed
annually by each full-time faculty member (after the initial
year) and will include results of the prior years plan,
a statement regarding how these results will be used to improve
the new plan, and a method for evaluating plan outcomes. For
more information please go to the Outcomes
Assessment page.
This is used for evaluating
career employees. You can complete part of the form on-line
and the comments sections will need to be completed manually
as the evaluation is taking place with the employee.
This form is used by the campus
administrator to approve payment for FT faculty who are offered
and accept an opportunity to teach a third full term during
a contract year.
To deselect a shaded date, click on the cell and select “no fill” from the toolbar. Revise the number of workdays to the right of the month; the running total for your calendar will then automatically adjust.
To select an alternate workday, click on the cell and fill by selecting a shade. Revise the number of workdays count to the right of the month; the running total will then automatically adjust.
Note: individual revisions to these calendars are permissible to meet student and institutional need per the provisions of Article 27: Workload.
*Faculty currently teaching a Fall/Summer base workload schedule, the week of August 17 may not be counted for scheduling purposes for 2009-10. Instead, the five work days adjustment is made in April, 2010.
This form is used
for Career, Professional and Administrative personnel to determine
daily working hours as agreed upon between employee and supervisor.