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 > Kwantlen Polytechnic University > Human Resources > Human Resource Services Forms

Human Resource Services Forms

Provided for your reference and use is a list of commonly required forms regarding a variety of employee/employment related matters.

Should you have any questions concerning a form or if you are having difficulty viewing or printing a form, please contact Human Resource Services at 604.599.2150.

Please note: If you are having problems viewing or printing these forms, , make sure you have Adobe Acrobat version 5 or later. You can download Acrobat Reader 5, at no charge, by clicking here. Follow the download instructions. Once you have installed the software, you will not have to download it again to view the form(s).

Please click on one of the following links to jump to a section:

Benefit Forms

FormatForm Name Comments
Adobe Acrobat Format MSP Group Change Form Completed by an employee to add/delete dependents, change name/address and forwarded to HR.
Adobe Acrobat Format Dental Claim Expense Form - No HCSA Completed by a dentist, either electronically or in paper format, to claim dental expenses from Manulife - BCGEU & Faculty.
Adobe Acrobat Format Dental Claim Expense Form - With HCSA Completed by a dentist, either electronically or in paper format, to claim dental expenses from Manulife - Administrative Employees.
Adobe Acrobat Format Extended Health Expense Form - No HCSA Completed by an employee to claim extended health expenses from Manulife - BCGEU & Faculty.
Adobe Acrobat Format Extended Health Expense Form - With HCSA Completed by an employee to claim extended health expenses from Manulife - Administrative Employees
Adobe Acrobat Format Group Benefits Application for Change Form Completed by an employee to make changes to their Benefits coverage, i.e. addition/deletion of dependent, change of name and forwarded to HR.
Adobe Acrobat Format Group Life Insurance - Application for Conversion Form Completed by a terminating/retiring employee who wishes to convert part or all of their group life insurance to a personal policy.
Adobe Acrobat Format Fair Pharmacare Registration Form Completed by an employee to register for Fair Pharmacare.
Adobe Acrobat Format MSP Group Application Form Completed by an employee when applying for the basic provincial medical coverage - Medical Services Plan.
Adobe Acrobat Format Manulife Enrollment or Re-enrollment Form Completed by an employee when enrolling or re-enrolling for benefit plans.
Adobe Acrobat Format Group Benefits - Evidence of Insurability Form Completed by an employee when enrolling for benefits outside of the eligibility period - late entrant application.
Adobe Acrobat Format Physician's Assessment of Work Abilities Form Completed by the attending physician for employee sick leave situations, when requested by Human Resource Services.
Adobe Acrobat Format Group Benefits Material Re-order Form Completed when supplies are required from Manulife.
Adobe Acrobat Format Change of Beneficiary Form Completed by an employee to change beneficiary for life insurance.
Adobe Acrobat Format Optional Life Application Form Completed when an employee is applying for additional life insurance from Manulife.

Recruitment and Employee Forms

FormatForm NameComments
MS Word Format Position Request Form (PRF) Completed by the hiring department to initiate the search process for new or replacement employee positions.
MS Word Format Employee Transaction Form (ETF) Completed by the Supervisor to identify and initiate changes to employee status.
MS Word Format HR Data Gathering Form Completed by an Employee to upon initial hire to inform Human Resource Services of personal, emergency contact, medical and credential information.
MS Word Format New Employee Checklist Information related to New Employee Setup
Web Page Link Change of Address/Telephone Form Completed by an Employee to change their address and/or telephone number in their Personnel Record.
Web Page Link SIN Card Application Completed by an Employee to apply for a replacement SIN card (card with legal name must be provided within 30 days of employment).
MS Word Format

BCGEU Performance Assessment
Completed by the Supervisor to assess and document both probationary and post probationary regular or posted auxiliary BCGEU employee performance.
MS Word Format Supervisor's Guide to Performance Assessments
MS Word Format Non-posted Auxiliary Employee Performance Assessment Completed by the Supervisor to assess and document non-posted auxiliary employee performance.
Web Page Link Faculty Evaluation Completed by the Supervisor to assess and document both probationary and post-probationary Faculty employee performance.

MS Word Format

Modified Schedules

Completed by a BCGEU employee to request a modified/flexible work schedule.

MS Word Format Flex Schedules
MS Word Format Educational Leave Application (Faculty) Completed by faculty employees applying for Educational Leave under article 14.
 Web Page Link BCGEU Leave Form  Completed by BCGEU employees requesting sick leave, special and other leave, maternity/parental leave, or leave of absence.
MS Word Format BCGEU Vacation Accrual Completed by auxiliary employees to select vacation accrual or payout.
MS Word Format BCGEU Union Dues Completed by an Employee to authorize deductions for union dues from bi-weekly pay or BCGEU members.
MS Word Format Deferred Salary Leave Application Completed by BCGEU, Faculty and Administrative Group to apply to participate in the Plan and defer a portion of their bi-weekly salary exclusively for the purpose of financing a future leave.
MS Word Format BCGEU Job Description Template Completed by Supervisors, with the assistance of Human Resource Services, and submitted to the Joint Job Evaluation Committee for review.
MS Word Format Student Assistant Job Description Template Completed by Supervisors, with the assistance of Human Resource Services, and submitted to the Union for approval.
MS Word Format Student Assistant Contract of Employment Completed by student assistant and supervisor, serves as formal offer and acceptance of employment.
MS Word Format Student Assistant Process Checklist Information related to hiring of student assistants

MS Word Format

Administrative Performance & Development Form

Completed by Administrators for Administrative Employees. Completed documentation to be forwarded to Human Resource Services.
Adobe Acrobat Format Competency Descriptions
Adobe Acrobat Format Supervisor Change Memo  
MS Word Format NR1 Sick Leave Application This form is to be completed by non-regular type 1 faculty who are claiming a loss of pay due to illness or injury.
MS Word Format Assignment of other duties

This form is to be completed by the Dean's office for faculty released from teaching to perform other duties as per article 2.03

Adobe Acrobat Format T2200 Guidelines Completed by the employer in order to support a claim on their personal income tax return for expenses related to their employment such as motor vehicle, supplies, travel, and work space at home.   

Faculty Appointment Forms

FormatForm NameComments
MS Word Format Faculty Search Summary Report Completed by the Search Committee to document the successful applicant(s) in Faculty Competitions.
MS Word Format Non-Regular Type 1 Contract Completed by the Hiring Department to document and initiate compensation for NRT1 contract faculty work as identified under Art. 1.05 (d) (i) and payable under Art. 10 of the Faculty Collective Agreement.
MS Word Format NR1 Contract Cancellation Completed by the Hiring Department to cancel NR1 contracts as outlined under Art. 5.06 of the Collective Agreement.
MS Word Format Non-Regular Type 2 Additional Work Contract Completed by the Hiring Department to document and initiate compensation for NRT2 faculty above their established annualized workload per Art. 1.05 (d) (iii) of the Faculty Collective Agreement.
MS Word Format NR2 Contract Cancellation Completed by the Hiring Department to cancel NR2 contracts.
MS Word Format Overload Contract Completed by the Department to document and initiate compensation for faculty teaching assignments that exceed 100% in their teaching year.

Occupational Health & Safety Forms

FormatForm NameComments
MS Word Format

Incident Investigation Form

Visit the Occupational Health & Safety website for a full description of each form and when to use it.
MS Word Format Incident Investigation Report
Adobe Acrobat Format Worksafe BC Form 6a Workers Report of Injury
Adobe Acrobat Format Worksafe BC Form 7 Employers Report of Injury