Human Resources

Forms & Policies


Dependent Children Tuition Allowance
Tuition allowance application for salaried employee dependent children.

Family/Medical Leave Application
This form is to be used in compliance with the Family and Medical Leave Act.

Free Tuition Hours Application
Application for hourly/salaried half/full time employees fee-free enrollment hours.

Health Plan Enrollment/Change Form
Use this form to enroll or change your employee health plan.

HME Employee Benefits
Benefits for hourly and salaried employees of Howell Mountain Enterprises.

HSA Enrollment Form
Enrollment Form for the take care Flex Benefits Plan.

Vacation/Sick Leave Request Form
Leave request form to use accrued paid/sick leave hours for hourly and salaried employees.

VALIC Salary Redirection Form
Redirect portions of your salary to VALIC retirement pension fund.


Direct Deposit Sign-Up Form
Sign up for Direct Deposit allowing Pacific Union College to directly deposit your paycheck into your bank account.

Personal Critical Data
Provide information to assist your family and Pacific Union College in the case of your death or incapacitation.

PUC Employment Application
Looking to become part of the PUC team? Fillable PDF instructions

Employee's Withholding Allowance Certificate.


Approved Counselor List
List of counselors that are approved by Human Resources.

Approved Massage Therapists
A list of approved Massage Therapists in the Angwin and St. Helena area.

Health Information Form*
This form provides PUC with your medical history and insurance information.

Health Release Form
This universal form can be used with PUC or your health care provider.

Health Savings Account



Annual Notice 2012
2012 Important Annual Notices

Clocking Policy for Time & Attendance
Description of allowed breaks/meals.

Confidential Information Policy
Treatment of Confidential Information.

Contract Teacher Policy
Hiring Policies for new contract teachers.

Housing Program Policy
Housing program policies for Faculty and Staff.

Problem Solving (Grievance) Procedure Policy
Solving misunderstandings in the workplace.

PUC Harassment Policy
PUC's harassment policy.

Salaried Exempt Vacation Policy
Policy for Salaried exempt employees concerning Vacation time.

Statement of Ethics
Responsibilities, values, and ethical responsibilities of Employer and Employees.

Student/Faculty Non-Fraternization Policy
Guidelines of relationships between Students and Faculty.


Beneficiary Designation
Designating a beneficiary for the PUC life insurance plan.

Driver Questionnaire
Questions about your driving record and accidents.

PUC Staff Handbook
Handbook for all Pacific Union College employees.

Purchase Reimbursements Form
Faculty/Staff Purchase Reimbursement Benefit for purchases on charge card.

Travel Authorization Request
Use this form to get travels pre-authorized.

Travel Expense Report
Use this form to log expenses during travel.

VALIC Salary Redirection Form
Redirect portions of your salary to VALIC retirement pension fund.

Worker's Compensation

Incident Report Form
Use this form to report incidents on campus.

Employer's Report of Occupational Injury or Illness
Workers' Compensation Claim Form (DWC 1) & Notice of Potential Eligibility

Employment Application Instructions

The PUC Employment Application is available as a downloadable PDF file. This PDF is a fillable form, which allows you to type into the PDF and then save it for emailing to Human Resources.

Tip: Once you are done filling out the PDF save the file to your desktop. Then, create a new email to and attach the PDF file to send to Human Resources. For more information on how to attach file please visit