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

Pay for Exceptional Performance

• Civil Service PFEP Guide
• COAP PFEP Guide
• PFEP FAQ

Sick Leave Bank Forms

• Donation/Revocation Form

Tuition Waivers

• Request to Enroll in University Classes (for current civil service employees)
• Request for Interinstitutional Waiver of Tuition
• Tuition Waiver for Children and Utilization Record (for university employees with 7 or more years of service)

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 CareSys at 800-773-3221 as the first step in filling a Workers' Compensation case.

All forms need to be completed for a work-related injury or illness. All completed forms should be sent to Human Resources. Please notify Human Resources when you involved in a work-related injury or illness, (309) 298-1971.

• Supervisor's Report of Injury or Illness
• Demands of the Job - Supervisor Form
• Workers' Compensation Employee's Notice of Injury
• Information Release Authorization - Employee Form
• Workers' Compensation Witness Report
• Illinois Workers' Compensation Commission Handbook

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