Western Illinois University: Macomb Campus

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Forms for Current University Employees

Civil Service Performance Evaluation Form

• Annual Performance Evaluation for Non-probationary Civil Service Employees

Civil Service Employment Transaction Request Form

• Request for Civil Service Personnel (for vacancies and employment changes)

Domestic Partner Benefit Program

• Domestic Partnership Declaration
• Domestic Partnership Termination
• Domestic Partner Premium Reimbursement Claim Form

Ethics Training

• Annual Ethics Training for New Hires (faculty, staff, undergraduate, and graduate), Seasonal, and Temporary Employees

I-9 Form

• Employment Eligibility Verification I-9 Form

Job Description Forms

• Instructions for Identifying Essential Job Functions
• Civil Service Job Description Form
• PAA Job Description Form

Lump Sum Payment Form

• Request for Lump Sum Payment

Miscellaneous Civil Service Forms

• Civil Service Employee of the Month Nomination Form
• Request for Employee Recognition Nominations
• Civil Service Dependent Scholarship Application Form

Sick Leave Bank Forms

• Donation/Revocation Form

Tuition Waivers

• Request to Enroll in University Classes (for current civil service employees)
• Request for Inter-Institutional Waiver of Tuition
• Tuition Waiver for Children and Utilization Record (for university employees with 7 or more years of service)
• Retired Employee Tuition Waiver form
• Tuition Waiver for Children of Domestic Partner
• Tuition Waiver for Spouse/Child of a Deceased University Employee
• Tuition Waiver for Children of Retired Employee

Workers' Compensation Forms

All employees must file a Workers' Compensation case within 45 days of the date of accident/injury per the Illinois Workers' Compensation Commission. View the Handbook on Workers' Compensation and Occupational Diseases.

All employees must call Tristar at 855-495-1554 as the first step in filling a Workers' Compensation case.

All forms need to be completed for a work-related injury or illness. Current worker's compensation forms can be found here.  All completed forms should be sent to Human Resources. Please notify the Workers' Compensation Coordinator, Amy Chambers, when you are involved in a work-related injury or illness, ( 309) 298-1971 .

Top Links

• SURS Employee Forum Presentation (PDF)
• Civil Service Handbook
• Benefits
• Civil Service Forms
• Microsoft Office Training

Other Resources

• Civil Service Employees Council News and Information
• Office of Equal Opportunity and Access
• Provost's Office
• Diversity Programs at Western
• Western Illinois University Board of Trustees
• Western Illinois University Chapter - State Universities Annuitants Association
• State Universities Civil Service System - (includes information about Statutes & Rules, Class Specifications, Employee Data, Procedures Manuals, and more)
• SURS - State Universities Retirement System of Illinois
• McDonough County Senior Services Directory
• CMS Deferred Compensation Plan - supplemental retirement plan open to all full-time state employees