Forms

Out of State Approval Request – Financial Services

Out of State Work Approval Request – Financial Services

Purpose: Use this form to request authorization for an employee to complete work for UNC Charlotte from a non-NC jurisdiction for a duration of greater than one (1) month. Note: This form must be submitted at least sixty (60) days prior to the proposed start date of the arrangement to permit an opportunity for receipt of all necessary approvals as indicated on the form. For more details, please refer to the Out-of-State Employees Guidance web page.

Last Updated: August 14, 2024

Paid Parental Leave Request

Paid Parental Leave Request

Purpose: Use this form to request eligibility for participation in the Paid Parental Leave (PPL) program.

Email Contact: benefits@charlotte.edu

Last Updated: August 14, 2024

Preferred Email Address Change Request

Preferred Email Address Change Request

Purpose: Use this form to request a preferred email address change (former employees).

Email Contact: employment@charlotte.edu

Last Updated: August 14, 2024

Prior Creditable State Service Verification Request

Prior Creditable State Service Verification Request (included with new hire forms)

Purpose: Use this form to request verification of creditable prior State service.

Email Contact: benefits@charlotte.edu

Last Updated: August 14, 2024

Professional Administrator Certification (PAC) Enrollment

Professional Administrator Certification (PAC) Enrollment

Purpose: Use this form to enroll in the Professional Administrator Certification (PAC) program.

Email Contact: hrtraining@charlotte.edu

Last Updated: August 14, 2024

Retention Bonus Request

Retention Bonus Request

Purpose: Use this form to request a retention bonus.

Last Updated: August 14, 2024

Secondary Employment

Secondary Employment

Purpose: Use this form to request approval of a secondary job with an external employer.

Email Contact: employment@charlotte.edu

Last Updated: August 14, 2024

Separation Notice

Separation Notice

Purpose: Use this form to provide advance notification of your intended separation from University service. Note: If you are retiring, changing positions within UNC Charlotte, completing a partial separation or student separation, you do not need to complete this form.

Email Contact: employment@charlotte.edu

Last Updated: August 14, 2024

Short Term Disability – Medical Report for Eligibility Review (Form 7A)

Short Term Disability – Medical Report for Eligibility Review (Form 7A)

Purpose: Use this form to request medical eligibility for short-term disability coverage under the Disability Income Plan of North Carolina.

Email Contact: benefits@charlotte.edu

Last Updated: August 14, 2024

Short Term Disability Benefits Earnings and Medical Eligibility Report (Form 703)

Short Term Disability Benefits Earnings and Medical Eligibility Report (Form 703)

Purpose: Use this form to report monthly certification from the medical provider for short term disability benefits.

Email Contact: benefits@charlotte.edu

Last Updated: August 14, 2024

Short Term Disability Benefits Request (Form 701)

Short Term Disability Benefits Request (Form 701)

Purpose: Use this form to request short-term benefits through the Disability Income Plan of North Carolina.

Email Contact: benefits@charlotte.edu

Last Updated: August 14, 2024

SHRA Grievance

SHRA Grievance

Purpose: Use this form to initiate the SHRA grievance process.

Email Contact: employee-relations@charlotte.edu

Last Updated: August 14, 2024

SHRA Supplemental Filing Form

SHRA Supplemental Filing Form

Purpose: Use this form to provide documentation in support of a SHRA grievance.

Email Contact: employee-relations@charlotte.edu

Last Updated: August 14, 2024

Sign On Bonus Request

Sign On Bonus Request

Purpose: Use this form to request a sign on bonus.

Email Contact: employment@charlotte.edu

Last Updated: August 14, 2024

Supplemental Employment

Supplemental Employment

Purpose: Use this form to request approval of a supplemental work assignment with the University.

Email Contact: employment@charlotte.edu

Last Updated: August 14, 2024