Download Medaille College badges to use in email signatures.

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 Letter Template and Position Description Template
• Hourly Attendance Sheet
• Key Request
• Lost/Missing Receipt Form
• Mileage Reimbursement Request
• Non-Employee Associate Form
• Position Approval Form
• 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

• • Independent Health Enrollment Form

• Flexible Spending Account (NOVA)
  • IMPORTANT NOTICE Change in Flexible Spending Accounts (effective 1/2011)
  • Flexible Spending Account Enrollment Form
  • Flexible Spending General Claim Form
  • Flexible Spending Direct Deposit Form
• Health Savings Plan (HSA)
  • HSA Enrollment Information
  • HSA Direct Deposit Form
• Dental (Lincoln Life and Annuity)
  • Dental Claim Form (rev. 11/10)
  • Group Dental Insurance Summary of Benefits (rev. 2/11)
• 403(b) (TIAA)
  • Medaille College Retirement Agreement for Salary Reduction under Section 403(b)
• Employee Tuition Waiver Benefit
  • Employee Tuition Waiver Procedures and Form Rev. 6/2022

Fax Forms

Printable versions of fax cover sheets for the Buffalo and Rochester Campuses.

• Buffalo Campus
• Rochester Campus

Tax and Governmental Forms

• IRS Form W-4 (2023) 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 (2023) from the New York State Tax Department (IT-2104)
• New York State Certificate of Exemption from Withholding (2023) 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.*
  *Please use the non-fillable version of the I-9 form if you are unable to use the filllable version

Additional Forms

• Business Card Policy and Ordering Information
• Create or update a medaille.edu website profile
• Driver Policy Form
• Event Form
  Event Registration and Room Reservation Policy and Procedures
• Faculty Textbook Order Form
• Institutional Research and Planning Survey Tracking Form: return to Mary Todd in 2 Agassiz.
• IT Equipment Request: return to the IT Department
• Marketing Request Form: Submit the online form.
• Photo Backdrop and Stand Request Form
• Profile Page: Create or Update My Website Profile
• Request for Permission to Drive Medaille College Vehicles
• Student Spotlight Nomination Form
• Supply Closet Request Form
• Title IX Reporting Guide
• Van Request Form
• VT Authorization for non-Medaille Animal on Campus
• VT Consent for Animal Use
• Do you have a suggestion for a form that should be added here? Please send an email to (webmaster@medaille.edu).

Payroll Information

• Direct Deposit form
• Stipend Request Form
• Lost Check Affidavit
• Request for Duplicate IRS Form W-2
• Payroll Schedule 2023
• Payroll Schedule 2022
• Hourly Attendance Sheet,  (hourly time sheet used only for closed pay periods)
• FWS Time 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