Support E-town
Information For

HR and Benefit Forms

You must be logged into a campus computer to view these forms.  If you would like paper copies of the forms, please stop by Human Resources in Alpha Hall.

2014 Benefits


Capital BlueCross website (to access provider directory, member login, etc.)

Capital BlueCross Enrollment/Change Form

CVS Caremark (prescription plan) Booklet

Delta Dental Enrollment/Change Form

Domestic Partner Benefit Policy

Emergency Contact Information Form

Employee Assistance Program

Family Recreation ID Request

Flexible Spending Account Payment Schedule

Flexible Spending Account Reimbursement Form - Dependent Care

Flexible Spending Account Reimbursement Form - Medical

FMLA Request Form

Liberty Mutual Insurance Flyer

Life Insurance Beneficiary Change Form

Name Badge Requests

Oil Discount Program

Pet Plan Insurance

Reasonable Accommodation Request Form

Reasonable Accommodation Request - Physician's Certificate

Service Leave Policy


Sick Leave Bank Provisions


TIAA-CREF Beneficiary Change Form

TIAA-CREF Defined Contribution Summary Plan Description 


TIAA-CREF - Salary Reduction Form

Tuition Remission / Exchange Forms

Verizon Wireless Employee Discount

Two Professors

  Sandi Hilsher, High Library

"I especially enjoy being around and assisting students as part of my job in the library." >Read more. 
Two Professors

Sanjay Paul, Department of Business

"I like how you can implement good ideas relatively quickly..." >Read more.
Two Professors

Mark Clapper, Alumni Relations

"...Having the opportunity to support a mission that is so noble and relevant ... is truly unique..." >Read more
Elizabethtown College