Forms and Worksheets
The following forms and worksheets are available for Medaille College faculty and staff.
- Banner Access
- Change of Status
- Check Request
- Credit Card Purchase Request
- Classroom Interruption Student Contact Information
- Direct Deposit
- Graduate Assistant Position Approval
- Hourly Attendance Sheet
- Key Request
- Lost/Missing Receipt Form
- Mileage Reimbursement Request
- Non-Employee Associate Form
- Position Approval Form 7/2017
- Work Program Position Approval Form
- Reimbursement for Associate Teachers
- Stipend Request Form
- Travel Expense Sheet
- Vacation Time Off Request
- Emergency Contact Form
Health Insurance and Benefits
- Medical Benefits Subscriber Claim Form (Group Number: 00412601) from BlueCross BlueShield of Western New York
- Flexible Spending Account (NOVA)
- Health Savings Plan (HSA)
- Dental (Lincoln Life and Annuity)
- 403(b) (TIAA-CREF and AXA Equitable)
- Employee Tuition Waiver Benefit
Printable versions of fax cover sheets for the Buffalo and Rochester Campuses.
- Buffalo Campus
- Rochester Campus
Tax and Governmental Forms
- IRS Form W-4 (2017) from the Internal Revenue Service
- Employee Opt-Out of Paid Family Leave Benefits
- New York State Notice of Wage Rate
- New York State Employee’s Withholding Allowance Certificate (2018) from the New York State Tax Department (IT-2104)
- New York State Certificate of Exemption from Withholding (2018) from the New York State Department of Taxation and Finance (IT-2104E)
- I-9 (Employment Eligibility Verification) from the United States Citizenship and Immigration Service. All new employees must submit this form and provide the proper identification as directed by this form.
- Business Card Ordering Form: return to College Relations at 73 Humboldt, Buffalo Campus.
- College Relations Data Request Form: return to Vicki Ward at 73 Humboldt, Buffalo Campus.
- Driver Policy Form
- Event Registration Form
Event Registration and Room Reservation Policy and Procedures
- Faculty Textbook Order Form
- Institutional Research and Planning Survey Tracking Form: return to Patrick McDonald in 2 Agassiz.
- IT Equipment Request: return to the IT Department
- Marketing Request Form: Submit the online form.
- Request for Permission to Drive Medaille College Vehicles
- Student Affairs Program Evaluation Form: return to Mary Johnson in the Student Affairs office, C203.
- Student Spotlight Nomination Form
- Title IX Reporting Guide
- Van Request Form
- VT Authorization for non-Medaille Animal on Campus
- VT Concent for Animal Use
- Do you have a suggestion for a form that should be added here? Please send an email to (firstname.lastname@example.org).
Paychecks for faculty, administrators and staff are delivered semi-monthly, on the 15th and 30th (or 31st) each month. For questions about direct deposit, check reissues, and PTO, please contact Mark Taylor, Payroll Manager, at (716) 880-2266 or by email at email@example.com.
- Direct Deposit form
- Stipend Request Form
- Lost Check Affidavit
- Request for Duplicate IRS Form W-2
- Payroll Schedule 2017
- Payroll Schedule 2018
- Hourly Attendance Sheet, (hourly time sheet used only for closed pay periods)
- Directions on how to submit an electronic timesheet through Web Time
- Directions on how to submit a monthly leave report through Web Leave