Forms

Division of Talent & Inclusion

Accommodations

Employee Request for Disability Accommodation (PDF) - This form to be completed by the employee when requesting an accommodation for a physical or mental disability.
Disability Accommodation – Health Care Provider Form (PDF) - This form to be completed by employee’s health care provider when requesting an accommodation for a physical or mental disability.
Religious Accommodation (PDF) - This form is to be completed by the employee when requesting a religious accommodation.
COVID-19 Employee Vaccination Requirement Accommodation (PDF) - Use this form when requesting a disability/medical or religious accommodation to WPI’s COVID-19 Employee Vaccination Requirement.

Benefits

Benefits Overview - Non-Exempt (PDF)
Benefits Overview - Exempt (PDF)
Affidavit of Domestic Partnership (PDF) - Declare domestic partnership for benefits
OPTUMRx COVID 19 Test Kit Reimbursement Request Form – Use this form to request reimbursement for FDA-authorized COVID-19 test kits purchased on or after January 15, 2022 at a retail store, pharmacy or online retailer.
Tuition - Dependent Children (PDF) - Request tuition for dependent children
Tuition – On-Campus Remission (PDF) - Request employee, spouse, and domestic partner tuition for on-campus classes
Tuition – Off-Campus Reimbursement (PDF) - Request employee tuition for off-campus classes
Tuition - WPI Graduate Level Course Job Related Designation Form (PDF) - This form is to be used by the supervisor to designate, based on course content and job responsibilities, that the course(s) taken is job related and should be excluded from taxation.
Retirement Application (Faculty) (PDF) - Dean and faculty member to discuss retirement and submit to HR
Retirement Verification Form (PDF)
BJ's Membership flyer and application form

Hiring

Foreign National Form (PDF) - For any foreign national on VISA
Form I-9 (PDF) - For employee verification
Remote I-9 Instructions - For any employee who is unable to travel to a Worcester Polytechnic Institute campus to complete their Form I-9. Please note: This form is not to be used by employees in Worcester.
IT Access for Employees and Non-employees - Hiring managers – request employee computer account
IT Access for Student Workers - Hiring Departments – request computer account for student workers
Recommended Appointment Rank for New Full or Part-time Faculty (PDF) - To be completed by academic department to review proposed appointment rank for new tenured, tenure-track, professors of practice, adjuncts, affiliates, and research faculty candidates.
Faculty Position Request Form - Provide position and funding details for new faculty recruiting and hiring.
Staff Position and Justification Request Form - Provide position and funding details and organization justification for staff recruiting and hiring
WPI New Employee Checklist

Non-Faculty Research Appointment

Non-Faculty Research Position - Titles Matrix (PDF)
Non-Faculty Research Extension Request Form (PDF)
Paid Non-Faculty Research Position Request Form – For hiring managers requesting a new paid non-faculty research position
Affiliate Non-Faculty Research Appointments (PDF) - Hiring managers – before making an offer for a non-faculty research candidate this form must be signed by the department and division
Visa Documentation for Non-Degree Graduate Student (PDF) - Visa documentation for non-degree graduate student
Visa Documentation for Visiting Scholars (PDF) - Visa documentation for visiting scholars

Payroll Changes & Taxes

Federal W-4 Form (PDF) (http://www.irs.gov) - IRS federal tax filing information and forms for reference only. Please complete this form in Workday.
Massachusetts State M-4 Form (PDF) (http://www.mass.gov/dor/) - Massachusetts tax filing information and forms for reference only. Please complete this form in Workday.
Faculty and Staff Pledge Form (PDF) - Make a gift to WPI through payroll deductions

Performance Management

Introductory Review - Employee Input - Form for employee to provide input at the end of their introductory period. Notification will come from HR for when to complete this form.
Introductory Review - Form to be completed by the manager for a new employee that has completed the introductory period. Notification will come from HR for when to complete this form.

Travel or Accident

Employee Accident Report (PDF) - Employees – complete when injured in the line of work
Travel Assistance Program (PDF) - Employees traveling on WPI-related business carry this information to be used in the event of accident or injury

Wellness Programs

Lunchtime Fitness - Registration & Liability (PDF) - More details: Wellness Programs

Finance

Visit Finance’s Frequently Used Forms for payments relating to check requests, expense reports, vendor and contractor forms, banner finance, bank services, p-card, sponsored research accounting, student organizations.