Forms

 

DRIVER SAFETY PROGRAM

DMV Pull Notice Form (DocuSign under ERM folder)

DSP Authorization (DocuSign under ERM folder)

STD 261 Authorization to Use Privately Owned Vehicles on State Business (DocuSign under ERM folder)

STD269 - State Accident Information Form

STD270 - State Vehicle Accident Report

STD274 - State Driver Accident Review Form (to be completed by driver's supervisor)

 

FOREIGN TRAVEL

21/22 Foreign Travel Insurance Program (FTIP) Coverage Summary

Acknowledgement of Travel Risks During the COVID-19 Pandemic (Faculty, staff, and non-study abroad program participants)

Foreign Travel Insurance Program (FTIP) Packet

Foreign Travel Participant List

Foreign Travel Schedule

International Transportation Charter Indemnification & Insurance Agreement

Request for Approval of Travel to High-Risk Country

Request for Foreign Travel Insurance Program (FTIP) Coverage

 

FOREIGN TRAVEL - FACULTY-LED STUDY ABROAD PROGRAM

FTIP Checklist - Faculty-Led Study Abroad Program

 

FOREIGN TRAVEL - STUDY ABROAD PROGRAM

Minors Medical Consent Form

Study Abroad - Acknowledgement of Travel Risks During COVID-19 Pandemic

Study Abroad - Foreign Travel Insurance Request Form

Study Abroad - Release of Liability for Personal Travel and Acceptance of All Risks

Study Abroad - Request for Authorization to Travel to a High Hazard Country

 

WAIVERS/RELEASES OF LIABILITY

Release of Liability Instructions

Release of Liability 

Release of Liability - Air/Ground Travel

 

WORKERS' COMPENSATION

Employee's Report of Work-Related Incident, Injury or Illness

DWC-1 Workers' Compensation Claim Form

DWC-1 Workers' Compensation Claim Form (Chinese)

DWC-1 Workers' Compensation Claim Form (Korean)

DWC-1 Workers' Compensation Claim Form (Tagalog)

DWC-1 Workers' Compensation Claim Form (Vietnamese)

Predesignation of Personal Physician

 

YOUTH PROTECTION PROGRAM

YPP - Youth Program Registration Form 2021

YPP - 3rd Party Youth Program Registration Form 2021

YPP - Abuse Reporting Guidelines (Also Available as a Template in DocuSign)

YPP - Code of Conduct - Standards for Interacting with Youth

YPP - Authorization/Consent to Provide Medical Services to a Minor

External Organization Campus Day Visit Agreement