Forms
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
Purpose: Use this form to request a retention bonus.
Last Updated: August 14, 2024
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
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
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
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
Purpose: Use this form to request a sign on bonus.
Email Contact: employment@charlotte.edu
Last Updated: August 14, 2024
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
Telework / Remote Work Agreement
Telework/Remote Work Agreement
Purpose: Use this form to request a telework or remote work arrangement.
Email Contact: employment@charlotte.edu
Last Updated: August 14, 2024