Paper employment applications are no longer available. Click on the link to apply for employment or to make an internal bid.

Departments complete this form, obtain approvals and contact Human Resources to request agency temporary personnel. Adecco procedures for UMDNJ

To document a counseling session between a staff member and his/her supervisor regarding issues such as performance, attendance, employee conduct or any other failure to follow policies/procedures. This is not to be used for issuing discipline.

To issue a formal disciplinary action, i.e., written warning; suspension without pay; written warning in lieu of suspension without pay; or termination. Prior to the issuance of a disciplinary action, Labor Relations must be consulted.

Complete these forms so that your employer can withhold the correct federal and state income tax from your pay. Because your tax situation may change, you may want to recalculate your withholding each year.

All U.S. employers are responsible for completion and retention of I-9 for each individual they hire for employment in the United States. This includes citizens and noncitizens.

To stop the withholding of New Jersey income tax, complete an Employee's Certificate of Non-Residence in New Jersey - Pennsylvania residents only.

Formerly Outside Employment, now resides on the Compliance Website

To initiate the Leave of Absence process, staff must complete and submit this form along with appropriate supporting documentation.

To obtain medical certification from a health care provider for a Leave of Absence request.

To evaluate the performance of employees working in facilities that require JCAHO review. Attach the employee’s specific Competency-Based Job Description/Performance Evaluation upon submission.

To evaluate the performance of employees working in facilities that require JCAHO review. Attach the employee’s specific Competency-Based Job Description/Performance Evaluation upon submission.

Supervisors complete this form approximately three weeks prior to the last day of the probationary period for newly hired, transferred or promoted staff.

This multi-purpose form is used to initiate changes in staff information, i.e., salary adjustments, organization codes, terminations and personal information such as marital status, address and name changes (must also present Social Security card for name changes).

To initiate position requests, i.e., new, replacement, acting appointments, and reclassifications.

To initiate the mandatory background check for a selected candidate before employment is finalized.  Also, to obtain a background check for volunteer applicants before volunteer service begins.

To initiate the mandatory background check for a selected faculty candidate before employment is finalized.  Also use this form to obtain a background check for volunteer faculty applicants.

To initiate background and criminal checks for employment candidates.

To request a criminal background check on selected candidates.

To be completed by applicants requesting volunteer staff assignments.

To be signed by volunteer applicants and department supervisors acknowledging waiver of coverage under the Workers Compensation Act.

ABP Retirement Application form

The Tuition Assistance Program application needs to be completed and received in HR 15 days prior to the start of the course.

This form is to be completed by employees who are eligible for the Benefits Assistance Program. Please submit the form to your Campus Benefits Representative.

The New Jersey State Health Benefits Program Employee Dental Plans Application needs to be completed when first enrolling or waiving your dental benefits. A new application is completed when making changes to the dental plan, or level of coverage. Please submit the application to your Campus Benefits Representative.

This form is needed by the Division of Pensions and Benefits when you as a member of a New Jersey State administered retirement system wish to make a change in beneficiary information for group life insurance or pension. (The pension plans are Public Employees Retirement System or Police and Firemen’s Retirement System.) If you are an Alternate Benefits Program member please call your investment provider directly to change the beneficiary information on your personal accounts. Please retain a copy for your own records and forward the forms to the address on the forms.

If you are a member of the Public Employees’ Retirement System or the Police and Firemen’s Retirement System and are applying for a pension loan. Please complete this form and either mail or fax to the Division of Pensions and Benefits, fax no. 609-341-2760 (applications only no cover letter)

The New Jersey State Health Benefits Program Application needs to be completed when you are first enrolling or waiving your medical or prescription benefits. A new application is needed when making changes to the medical or prescription plan or level of coverage. Please submit the application to your Campus Benefits Representative.

If you are an active member of either the PERS or PFRS and are interested in purchasing eligible service credit, please complete the application and forward to the Division of Pensions and Benefits. The address is on the form.

The above link is to the Division of Pensions and Benefits, PERS and PFRS retirement applications with additional retirement information.

The Salary Reduction/Allocation Agreement form is used to make changes in existing mandatory or voluntary pretax employee contributions for either the Alternate Benefit Program (ABP) or Additional Contributions Tax Sheltered (ACTS) Plan.

This form is needed when you are waiving or reinstating your health benefits coverage. Please submit this form along with the Medical Application (New Jersey State Health Benefits Program Application) to your Campus Benefits Office.

This form needs to be completed when staff members are requesting approval to be a recipient of donated time from coworkers (staff) for a life-threatening or catastrophic illness for themselves or immediate family members.

This link to the Division of Pensions and Benefits will take you to the form section of the State Health Benefits Program. You will be able to download additional forms such as claim forms for medical, dental and prescription along with SHBP Retire Status Applications.

The Temporary Disability Insurance claim form would be completed by you and your doctor at the time you are going out on an approved unpaid leave of absence. This form can be returned to either your Campus HR Generalist or Campus Benefits Representative.

The above link to the PERS and PFRS withdrawal applications will allow you to print the application, complete it or fill it out on line and then print. The entire withdrawal application should be returned to your Campus Benefits Representative for processing. If you are already signed up for the Division of Pensions and Benefits Members Benefits Online System (MBOS) you could complete the application on line and submit through MBOS.