Institutional Forms

The institutional forms repository will be updated to a new version after the Spring 2014 semester. The new version of the institutional forms repository is currently available for preview.

Preview the new Institutional Forms Repository

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 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.

If you have any forms to add or update, please email webmaster@fairmontstate.edu.

To skip to a specific section, click on the name.

Faculty/Staff Forms   Students Forms
  Academic Affairs     Admissions
  Bookstore     Financial Aid/Scholarships
  Business Office     Registrar
  Copy Center     Graduate Studies
  Creative Services     Fairmont State University
  Facilities & Capital Projects (Physical Plant)      
  Faculty & Staff Awards and
Foundation Grants
     
  Fine Arts      
  Human Resources     Student Affairs - Campus Life
  Information Technology     Student Affairs - Student Services
  Leadership Marion     Student Affairs - Student Activities
  Libraries   Public Forms
  Miscellaneous     Community Service Learning
  Public Relations & Marketing     FSU Foundation Giving Opportunities
  Sponsored Grants Accounting     GEAR UP
  Web & Graphic Communications     Public Safety
         
         

**PDF files require Adobe Acrobat Reader

 

FACULTY & STAFF FORMS


Academic Affairs (aa)


Form Name File Name/Type Description/Notes Contact Updated
Application for Promotion
Directions |Word Doc
Cover Sheet |PDF Form print and sign Kathy Cox 10/11
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 Kathy Cox 10/11
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 Kathy Cox 11/08
Evaluation for Probationary Faculty - 1st & 2nd Year
Directions |Word Doc
Self-Evaluation |Word Form print and sign Kathy Cox 9/08
Peer Evaluation |Word Form print and sign
Chair Evaluation |Word Form print and sign
Sabbatical Application Application |Word Form print and sign Kathy Cox 5/08
Agreement |PDF Form print, sign, & notarize
Dean and Provost
Evaluation Tool
Evaluation Tool|Word Doc print and sign Kathy Cox 5/08
Dean/Chair Evaluation
Directions |Word Doc
Dean Evaluation |PDF Form   Kathy Cox 5/08
Curriculum Proposal Curriculum Proposal Form |Word Doc instructions Jack Kirby 9/10
Approved Outcomes Language |Word Doc instructions 2/12
Curriculum Proposal Process |Word Doc instructions 11/12
 
Online Course Peer Evaluation Form Online Course Peer Evaluation Form |Word Doc print and sign Roxann Humbert 11/08
General Studies Inclusion General Studies Inclusion | PDF   Christina Lavorata 10/11
Employee Tuition Waiver FSU PCTC Waiver | PDF print and sign Jack Kirby 10/13

Program Review Form - Academic Affairs |Word Doc (contact: Christina Lavorata)

Bookstore (bk)

Cap and Gown Request Form |Drupal Form (contact: Patti Miller)
Course Book Information Request |HTML (contact: Shelley Fox)
Course Pack Order Form |PDF (contact: Shelley Fox)
Publisher Information Form | PDF (contact: Shelley Fox)

Business Office (bo)

BO - Accounts Payable
Association Dues Approval Form |PDF (contact: Holly Fluharty)
Employee Reimbursement Request: WVSAO ER1 |PDF (contact: Holly Fluharty)
Individual Association Due Agreement |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 |PDF (contact: Holly Fluharty)
Vendor's Invoice |PDF (contact: Holly Fluharty)
Wireless Device Stipend Agreement |Word Doc (contact: Holly Fluharty)

BO - Inventory
Asset Disposal Reporting Form | PDF (contact: Caroly Fletcher)
Capital Equipment Transfers Reporting Form | PDF (contact: Caroly Fletcher)
Lost or Stolen Form | PDF (contact: Caroly Fletcher)
Return to Vendor Trade In Form | PDF (contact: Caroly Fletcher)

BO - Cash Handling
Cash Count Form | PDF (contact: Christa Kwiatkowski)

BO - Procurement
Account Codes – FY 2014 PDF
Catering Request |Word Doc (contact: Monica Cochran)
Catering Request Procedures |Word Doc (contact: Monica Cochran)
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)
Purchasing Manual |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)
Student Award Prize |PDF (contact: Becky Miller)
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)
WV-96A: WV Vendor Agreement for Software |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 Manual |PDF (contact: Becky Miller)
P-Card Missing Receipt Form |PDF (contact: Becky Miller
P-Card Purchase Justification |PDF (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)

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.

Creative Services (cs)

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)

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)

Please visit the Center for Teaching Excellence page for the current forms and information.

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
Exemption Claim Form |PDF
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
Parking Deduction Form |PDF
Prior Payment Form |PDF
Temporary Appointment Fringe Benefits Calculation forms: (Full Time) |Excel (Part Time) |Excel
Temporary Appointment For Special Program Online Instructions |PDF (contact: Maria Marshall)
Employee Fringe Benefits Calculation forms (Full Time) / Excel (Part Time) / Excel
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)
Important 403(b) Retirement Notice

City of Fairmont Street Maintenance Charge
Instructions
Exemption Claim Form
Prior Payment Form
Refund Claim Form

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
FSU Voluntary Phased Retirement Plan Form | PDF (Please meet with HR as a first step in this process)
Pierpont 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
Direct Deposit Form |PDF (contact: Cinda Lu Ewing)

Information Technology (it)

IT - Administrative Systems
Project Request Form |Excel
Banner Access Request
Exit Form

IT - Application Applications
Request to Migrate Section Template

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 - Teaching & Learning Commons
Expense Transfer
IT Purchase Authorization Form |PDF (contact: Joanie Raisovich)

IT Work Order
Creating WebDAV Folders in Windows
Importing WebCT CE Content into Vista
Request to Migrate Section Template

Leadership Marion (lm)

Brochure |PDF (contact: Budd Sapp)
Application |PDF (contact: Budd Sapp)

Libraries (lib)

Library Instruction Request Form (On and Off-Campus) |HTML (contact: Charley Hively)

Miscellaneous

Permit to use alcoholic beverages on campus |PDF

Public Relations and Marketing (pr)

Submit a story idea?

Sponsored Grants Accounting (rs)

Grant Pre-Certification Form (GPCF) |Word Doc (contact: Sandy Shriver)
Final Proposal Certification Form (PCF) |Word Doc (contact: Sandy Shriver)
Grant Budget Creation Request |Excel Form (contact: Sandy Shriver)
Transfer of Funds Request |Excel Form (contact: Sandy Shriver)
Institutional Review Board (IRB) “Human subjects” Application |Word Doc (contact: Clarence Robrbaugh)
Informed Consent Form |Word Doc (contact: Sandy Shriver)

STUDENT FORMS


Return to Content List

Admissions (adm)

Campus Visit Information (Schedule Individual or Group Tours) |HTML (contact: Amie Fazalare)
Graduate Application for Admission |PDF (contact: Jack Kirby)
Join Our Mailing List |HTML
Online Undergraduate Application for Admission |HTML (contact: Amie Fazalare)
Undergraduate Application for Admission & Residence Hall Lease |PDF (contact: Amie Fazalare)
Selective Program |PDF Form
Application - Signature Page |PDF Form
Residency Application |PDF Form
Sponsor Form |PDF Form
Transfer Eligibility |PDF Form

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 Scholarship Application |PDF
Application for PROMISE Scholarships & the WV Higher Education Grant |HTML
Charles J. McClain Presidential Scholarship |PDF *Note: for PROMISE Scholarship recipients


Multicultural Affairs:
Hunt-Arnold Scholarship Application |Drupal Form (contact: Tara Brooks) *Note: Not currently accepting applications - all awards have currently been disbursed.

Registrar's Office (ro)

Change of Major (contact: Enrollment Services)
Change of Name and/or Address |PDF (contact: Enrollment Services)
Enrollment Services Override Form |PDF (contact: Evie Brantmayer)
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)
GED Request Form |PDF Form
FERPA Release |PDF Form

Graduate Studies - Student Resources and Forms (gs)

Graduate Assistantship Application |PDF (contact: Alicia Nieman)
Concurrent Enrollment Application Form |PDF (contact: Alicia Nieman)
Degree Plan |PDF (contact: Alicia Nieman)
Graduate Faculty Membership And Application Form |PDF (contact: Alicia Nieman)
Graduation Checklist |PDF (contact: Alicia Nieman)
Special Course Approval Form |PDF (contact: Alicia Nieman)
Student Checklist |PDF (contact: Alicia Nieman)
Transfer of Graduate Credit Request Form |PDF (contact: Alicia Nieman)
Credit Load Exception | PDF (contact: Alicia Nieman)

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
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

Student Affairs - Campus Life (sl)

Residence Life (Housing)
Combined Lease Agreement  | PDF (contact: Tish Cavicchio)
On-Campus Exemption Request Form |PDF Form (contact: Tish Cavicchio)
Special Housing Accommodation Request |Word Doc (contact: Tish Cavicchio)

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 | (contact: Andrea Pammer)
Rehabilitation Act Section 504 |HTML Section 508 |HTML(contact: Andrea Pammer)
Tutor Request Form |Word Doc (contact: Andrea Pammer)


International Students
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
Acknowledgement of Risk
Physical Form
Insurance Protocol
Athletic Competition Release
Medical Information Release
Medical History

Student Organizations/Clubs
Request for Fundraiser
Student Organization/Club Activity Report Form
Student Organization Leadership Updates
 

PUBLIC FORMS


Return to Content List

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)

Make Your Gift

Public Safety (ps)