Dear New Employee Welcome to BMCC. Attached are a variety of documents concerning your appointment to the college that you need to be aware of or must complete. Please read these materials carefully and provide all of the requested information as quickly as possible. The offer of this employment is conditional upon satisfactory completion of all verifications, including but not limited to confirmation employment and background checks. We hope you will enjoy your experience at the college. Best wishes for a productive and successful career at BMCC. Sincerely, Robert E. Diaz Vice President for Legal Affairs and Faculty & Staff Relations /New Employee
Transcript
Dear New Employee Welcome to BMCC. Attached are a variety of documents concerning your appointment to the college that you need to be aware of or must complete. Please read these materials carefully and provide all of the requested information as quickly as possible.
The offer of this employment is conditional upon satisfactory completion of all verifications, including but not limited to confirmation employment and background checks. We hope you will enjoy your experience at the college. Best wishes for a productive and successful career at BMCC. Sincerely,
Robert E. Diaz Vice President for Legal Affairs and Faculty & Staff Relations /New Employee
EMPLOYEE NAME: CUNYFirst #:
Department: EMPLOYEE TITLE: College Assistant
Following for Office Use ONLY:
INITIAL & DATEEnd Date/Length of
appointment Pay Rate
START DATE
I‐9 COMPLETE
P.A.F. RECEIVED
PACKET RECEIVED Packet Completed:
PMS PMS #
CUNYFirst P.O.#
Schedule Of Classes Received:
Glacier Form
Finger Printing Money Order:
KRONOS (Classified Staff) Entered in System: Registered:
The following should be used as a guide to insure you are providing Human Resources with all necessary paperwork and information upon acceptance of offered position. Please take time to familiarize yourself with the following:
Appointment Processing and Fees Time and Leave System (Kronos) Various Policies/Procedures available on our BMCC HR Website
When you accept an offer of employment with the Borough of Manhattan Community College, you must present ORIGINAL documents as outlined below.
Proof of Identity and Employment Eligibility
Under federal law you must complete an Employment Verification (I-9) form in the presence of an HR officer. Be sure to bring appropriate proof of identity/eligibility to HR before your first day of work.
Social Security Card-for Payroll Purposes Acceptance Letter Personnel Information Form CUNY Employment Application-Part 1 CUNY Employment Application-Part 2 Amended Constitutional Oath Emergency Contact Form Agency Shop Fee Agreement New Hire Account Request Form Report of External Employment for Classified Staff
Payroll:
Timesheet checklist for new College Assistants Employee’s withholding allowance certificate (W-4 and IT-2104) Direct Deposit of Net Pay Enrollment (If applicable)
Benefits:
Wage Works-Commuter Benefits Program Form
The timing of your initial pay check will be based on the process and our receipt of the above documents. If you have any questions about your appointment or payroll process, please call us at 212-220-8300. _____________________________ _________________________ Print Name Date _____________________________ Signature
To: Supervisors, Office Heads, and Applicants to the Position of College Assistants or
Tutors From: Human Resources Date: August 20, 2009 Subject: Appointment Processing and Fees For all applicants to the position of College Assistants or Tutors, the following requirements must be completed prior to the first day of employment.
Fingerprinting Fee of $87.25 will be required from all applicants who are NOT full time CUNY students (please see the Procedures for Candidates Fingerprinting Using L-1 Identity Solutions Letter).
Full time CUNY students will not have to pay this fingerprinting fee. However, you will need to provide proof of student status Each Semester in order to waive the fingerprinting fee. (ex. Tuition Bill or a letter from the Registrar’s Office)
All applicants who are appointed for 239 hours or more must pay Application Processing Fee, by US Postal Money Order ONLY, payable to the City University of New York (CUNY) for $15.00
All applicants MUST be verified for Compliance with the Immigration Reform and Control Act (IRCA) within three days of your appointment for both identity and the required employability certification. See the Reverse side of this Memorandum of IRCA documentation.
Applicants MUST provide an original social security card.
All Tutors must submit official proof of highest degree earned.
If the above procedures are not completed, we will be unable to either process or release salary checks. The Human Resources Office has been authorized to withhold salary checks and/or remove from the payroll all College Assistants/Tutors who fail to complete these appointment-processing requirements. Thank you.
Office of Human Resources Management Campus HR Advisory Services 205 East 42nd Street, 10th floor New York, N.Y. 10017 646-664-3311 Fax 646-664-3836
5. Payment for fingerprinting services is required at the time of the fingerprinting appointment. MorphoTrust USA accepts personal check, money order, business check, credit card, e-check, and escrow account transactions.
6. Fingerprint technicians do not have access to credit card machines at the fingerprint
locations, so applicants cannot pay for their fingerprinting by credit card on location. This will need to be done via the web at www.identogo.com or by calling into the call center at 1- 877-472-6915.
Final Note: Fees for fingerprint services vary depending on the type of background check
required. The fees assessed by MorphoTrust USA include the fingerprint rolling charges and any fingerprint processing charges levied by the Department of State. MorphoTrust USA collects the fee for each applicant and makes the appropriate payments to the Division of Criminal Justice Services on behalf of the applicants.
Appointments are required at all locations - please proceed to the appointment
registration page and set up an appointment time for your fingerprinting or call toll-free 877-472-6915
Location listing is accurate as of Friday, February 07, 2014 locations are subject to change without notice.
NEW YORK METRO
Bronx - E 149Th St Bronx, NY. 349 E 149th St, Ste 605 Mon, Tue, Thu & Fri 9:00 - 5:00; Wed 9:00 - 6:00; E/O Sat 10:00 - 2:00
Bronx - Third Ave - Between 147th & 148th St Bronx, NY. 2804a Third Ave Mon- Fri 9am-12pm & 1pm-8pm; Sat 9:00am-12pm & 1pm-5:00pm
To: All Members of the Classified Staff From: Human Resources Subject: Kronos Time and Leave System This memorandum is written to reacquaint you with the College’s policy: 1. Classified staff is required to record their time upon arrival and departure by inputting their
ID and finger images into the Kronos Touch ID System. Clocks are located throughout the
College Campuses. You should record your time of arrival and departure at the building of
your assigned work location. Before leaving the time clock, you should verify that the clock
recorded your punch. The “Accepted Punch” message is you indication that your time is
recorded.
2. In the instances where punches are not recorded, your supervisor/office head must provide a
written statement verifying attendance and the specific hours worked to Human Resources.
3. In order to enhance the service, we ask that you immediately inform us and your supervisor
when you are experiencing problems with the Kronos Touch ID Device.
Should you need additional information please call ext. 8300
Signature Date
SwipePolicy3
Policies and Procedures are available on BMCC HR Website:
Acceptable use of computer resources
Statement of ADA/504
Children on Campus
CUNY Policy on Drug and Alcohol
Domestic Violence and the Workplace Violence Prevention Policy and Procedures
CUNY Policies and Procedures on Non-Discrimination and Sexual Harassment
Equal Opportunity/Affirmative Action Policy
CUNY Policy and Procedures Concerning Sexual Assault, Stalking and Domestic and Intimate Partner Violence against Students
CUNY Sexual Misconduct Policy
Time Off for Donating Blood
Time Off for Religious Observance
I understand that I am expected to review and familiarize myself with the above policies prior to commencing employment and agree to do so. _____________________________________________________ Signature Date ________________________________ Print Name J:/Policies & Procedures – BMCC HR Web
LISTS OF ACCEPTABLE DOCUMENTSAll documents must be UNEXPIRED
Employees may present one selection from List A or a combination of one selection from List B and one selection from List C.
3. Foreign passport that contains a temporary I-551 stamp or temporary I-551 printed notation on a machine-readable immigrant visa
4. Employment Authorization Document that contains a photograph (Form I-766)
5. For a nonimmigrant alien authorized to work for a specific employer because of his or her status:
Documents that Establish Both Identity and
Employment Authorization
6. Passport from the Federated States of Micronesia (FSM) or the Republic of the Marshall Islands (RMI) with Form I-94 or Form I-94A indicating nonimmigrant admission under the Compact of Free Association Between the United States and the FSM or RMI
b. Form I-94 or Form I-94A that has the following:(1) The same name as the passport;
and(2) An endorsement of the alien's
nonimmigrant status as long as that period of endorsement has not yet expired and the proposed employment is not in conflict with any restrictions or limitations identified on the form.
a. Foreign passport; and
For persons under age 18 who are unable to present a document
listed above:
1. Driver's license or ID card issued by a State or outlying possession of the United States provided it contains a photograph or information such as name, date of birth, gender, height, eye color, and address
9. Driver's license issued by a Canadian government authority
3. School ID card with a photograph
6. Military dependent's ID card
7. U.S. Coast Guard Merchant Mariner Card
8. Native American tribal document
10. School record or report card
11. Clinic, doctor, or hospital record
12. Day-care or nursery school record
2. ID card issued by federal, state or local government agencies or entities, provided it contains a photograph or information such as name, date of birth, gender, height, eye color, and address
4. Voter's registration card
5. U.S. Military card or draft record
Documents that Establish Identity
LIST B
OR AND
LIST C
8. Employment authorization document issued by the Department of Homeland Security
1. A Social Security Account Number card, unless the card includes one of the following restrictions:
2. Certification of Birth Abroad issued by the Department of State (Form FS-545)
3. Certification of Report of Birth issued by the Department of State (Form DS-1350)
4. Original or certified copy of birth certificate issued by a State, county, municipal authority, or territory of the United States bearing an official seal
5. Native American tribal document
7. Identification Card for Use of Resident Citizen in the United States (Form I-179)
Documents that Establish Employment Authorization
6. U.S. Citizen ID Card (Form I-197)
(2) VALID FOR WORK ONLY WITH INS AUTHORIZATION
(3) VALID FOR WORK ONLY WITH DHS AUTHORIZATION
(1) NOT VALID FOR EMPLOYMENT
Page 3 of 3Form I-9 11/14/2016 N
Examples of many of these documents appear in Part 8 of the Handbook for Employers (M-274).
Refer to the instructions for more information about acceptable receipts.
USCIS Form I-9
OMB No. 1615-0047 Expires 08/31/2019
Employment Eligibility Verification Department of Homeland Security
U.S. Citizenship and Immigration Services
Form I-9 11/14/2016 N Page 1 of 3
►START HERE: Read instructions carefully before completing this form. The instructions must be available, either in paper or electronically,
during completion of this form. Employers are liable for errors in the completion of this form.
ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which document(s) an employee may present to establish employment authorization and identity. The refusal to hire or continue to employ an individual because the documentation presented has a future expiration date may also constitute illegal discrimination.
Section 1. Employee Information and Attestation (Employees must complete and sign Section 1 of Form I-9 no later than the first day of employment, but not before accepting a job offer.)Last Name (Family Name) First Name (Given Name) Middle Initial Other Last Names Used (if any)
Address (Street Number and Name) Apt. Number City or Town State ZIP Code
Date of Birth (mm/dd/yyyy) U.S. Social Security Number
- -
Employee's E-mail Address Employee's Telephone Number
I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in connection with the completion of this form.
I attest, under penalty of perjury, that I am (check one of the following boxes):
1. A citizen of the United States
2. A noncitizen national of the United States (See instructions)
3. A lawful permanent resident
4. An alien authorized to work until (See instructions)
(expiration date, if applicable, mm/dd/yyyy):
(Alien Registration Number/USCIS Number):
Some aliens may write "N/A" in the expiration date field.
Aliens authorized to work must provide only one of the following document numbers to complete Form I-9: An Alien Registration Number/USCIS Number OR Form I-94 Admission Number OR Foreign Passport Number.
1. Alien Registration Number/USCIS Number:
2. Form I-94 Admission Number:
3. Foreign Passport Number:
Country of Issuance:
OR
OR
QR Code - Section 1 Do Not Write In This Space
Signature of Employee Today's Date (mm/dd/yyyy)
Preparer and/or Translator Certification (check one): I did not use a preparer or translator. A preparer(s) and/or translator(s) assisted the employee in completing Section 1.(Fields below must be completed and signed when preparers and/or translators assist an employee in completing Section 1.)I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct.
Signature of Preparer or Translator Today's Date (mm/dd/yyyy)
Last Name (Family Name) First Name (Given Name)
Address (Street Number and Name) City or Town State ZIP Code
Employer Completes Next Page
Form I-9 11/14/2016 N Page 2 of 3
USCIS Form I-9
OMB No. 1615-0047 Expires 08/31/2019
Employment Eligibility Verification Department of Homeland Security
U.S. Citizenship and Immigration Services
Section 2. Employer or Authorized Representative Review and Verification (Employers or their authorized representative must complete and sign Section 2 within 3 business days of the employee's first day of employment. You must physically examine one document from List A OR a combination of one document from List B and one document from List C as listed on the "Lists of Acceptable Documents.")
Last Name (Family Name) M.I.First Name (Given Name)Employee Info from Section 1
Citizenship/Immigration Status
List AIdentity and Employment Authorization Identity Employment Authorization
OR List B AND List C
Additional Information QR Code - Sections 2 & 3 Do Not Write In This Space
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Certification: I attest, under penalty of perjury, that (1) I have examined the document(s) presented by the above-named employee, (2) the above-listed document(s) appear to be genuine and to relate to the employee named, and (3) to the best of my knowledge the employee is authorized to work in the United States.
The employee's first day of employment (mm/dd/yyyy): (See instructions for exemptions)
Signature of Employer or Authorized Representative Today's Date(mm/dd/yyyy) Title of Employer or Authorized Representative
Last Name of Employer or Authorized Representative First Name of Employer or Authorized Representative Employer's Business or Organization Name
Employer's Business or Organization Address (Street Number and Name) City or Town State ZIP Code
Section 3. Reverification and Rehires (To be completed and signed by employer or authorized representative.)A. New Name (if applicable)Last Name (Family Name) First Name (Given Name) Middle Initial
B. Date of Rehire (if applicable)Date (mm/dd/yyyy)
Document Title Document Number Expiration Date (if any) (mm/dd/yyyy)
C. If the employee's previous grant of employment authorization has expired, provide the information for the document or receipt that establishes continuing employment authorization in the space provided below.
I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if the employee presented document(s), the document(s) I have examined appear to be genuine and to relate to the individual.
Signature of Employer or Authorized Representative Today's Date (mm/dd/yyyy) Name of Employer or Authorized Representative
Borough of Manhattan Community College
Office of Human Resources
Personnel Information Form
Name (print) Social Security Number Title Department Date of Appointment
☐ Female ☐ Male Date of Birth__________________________
Ethnicity:
☐ African American ☐ Alaskan Native ☐ American Indian ☐ Asian
☐ Black ☐ Hispanic ☐ Italian American
☐ Pacific Islander ☐ Puerto Rican ☐ White ☐ Other
U.S. Citizen: ☐ Yes ☐ No If you are not a U.S. Citizen,
Of what country are you a citizen? What type of VISA are you holding: Expiration Date:
Are you a Veteran? ☐ Yes ☐ No If you are a veteran, please specify:
☐ Active Reserve ☐ Disabled ☐ Disabled Vietnam Era
☐ Inactive Reserve ☐ Retired ☐ Vietnam Era Home Address: (print) Telephone Number: E‐Mail Address Emergency Contact: Relationship: Address: Telephone Number: Business Number:
Education: Degree Major Date Earned Institution___________
Borough of Manhattan Community College 199 Chambers Street The City University of New York New York, NY 10007·1097 www.bmcc.cuny.edu te.l 212·220-8300
fax 212·220.2364
Primary:
Name of Emergency Contact:
Relationship:
Address:
Home Phone Number:
Business Number:
Cell Phone Number:
Secondary:
Name of Emergency Contact
Relationship:
Address:
Home Phone Number:
Business Number:
Cell Phone Number:
Name (Print) Department
\
Signature Date
HR 5-2011
BOROUGH OF MANHATTAN COMMUNITY COLLEGE
THE CITY UNIVERSITY OF NEW YORK
TO: The Director of Human Resources
I accept this College Assistant position with the understanding that the hours I
can work will be limited to 1040 per fiscal year (July 1st ‐ June 30th).
Name
Signature
Date
TO: The College Assistant Applicant
A College Assistant working more than 5 hours but less than 6 hours per day
must take a lunch break of ½ hour.
A College Assistant working more than 6 hours a day must take a lunch break of
at least 1 hour.
AMENDED CONSTITIUTIONAL OATH UPON APPOINTMENT
(In compliance with Section 62 of the New York State Civil Service Law)
“I hereby pledge and declare that I will support the Constitution of the United States
and the Constitution of the State of New York and that I will faithfully discharge the
duties of the Position of according to the best
of my ability”
Name:
Signature:
Address:
Date:
Our Commitment to Diversity Diversity and inclusion are core values of The City University of New York (CUNY or The University). We believe adherence to these values creates an environment that best allows our students, faculty and staff to learn, work and succeed. As a University, we strive to respect differences, but more importantly, we seek to leverage the talents of all members of the University community in order to foster academic and administrative excellence. These values make CUNY a great place to learn and work! Equal Opportunity and Non-Discrimination Policy
The University is committed to a policy of equal employment and equal access in its educational programs and activities. Diversity, inclusion, and an environment free from discrimination are central to the mission of the University. It is the policy of the University-applicable to all colleges and units-to recruit, employ, retain, promote, and provide benefits to employees (including paid and unpaid interns) and to admit and provide services for students without regard to race, color, creed, national origin, ethnicity, ancestry, religion, age, sex (including pregnancy, childbirth and related conditions), sexual orientation, gender, gender identity, marital status, partnership status, disability, genetic information, alienage, citizenship, military or veteran status, status as a victim of domestic violence/stalking/sex offenses, unemployment status, or any other legally prohibited basis in accordance with federal, state and city laws.
It is also the University’s Policy to provide reasonable accommodations, when appropriate, to individuals with disabilities, individuals observing religious practices, employees who have pregnancy or child-birth related medical conditions, or employees who are victims of domestic violence/stalking/sex offenses.
All questions or concerns regarding the University’s non-discrimination policy or procedure, or the application of that procedure, should be addressed to the College’s Chief Diversity Officer. Inquiries or complaints concerning sex discrimination and sexual misconduct may be referred to the College’s Title IX Coordinator or to the Office for Civil Rights of the United States Department of Education. Disability Accommodation Available for Applicants
If you require an accommodation for a disability in order to participate in the selection process, please contact the College's Office of Human Resources. Military Service
If you are claiming preference for military service, you will be required to submit an original DD 214 along with verification of your disciplinary record. Professional References
Current and former employers may be contacted for verification of any and all information stated in this application or obtained during any phase of the selection process. In order for CUNY to obtain this information, please complete the Authorization to Release Reference Information form agreeing to hold any and all of your reference sources harmless and free of any liability for releasing information CUNY deems relevant to determining whether to employ you. Applicants who do not want their current employer to be contacted prior to receiving an offer of employment are required to make such a request and provide reasons therefor.
THE CITY UNIVERSITY OF NEW YORK EMPLOYMENT APPLICATION - PART ONE
Important Notice to Applicants
Name
Position
CUNY EMPLOYMENT APPLICATION - PART ONE March 2016
Page 1 of 7
Dept.
College
THE CITY UNIVERSITY OF NEW YORK
APPLICATION FOR EMPLOYMENT- PART ONE
Position Title
If part-time, hours available
Contract Title
Last Name
P.M.
A.M.
Personal Information
First Name Middle Initial
If known by another name, please provide
Address
City State Zip Code
Apt. #
Daytime Phone #
Evening Phone #email
Do you have any relatives employed in the department for which you are applying?
If yes, please explain
Are you permitted to work in the United States?
Applicant Attestation: By my signature below, I declare and affirm that I have read and fully understand that: - Any misrepresentation or material omission of facts in this application or in any other materials I submit in support of my candidacy (including but not limited to the letter of application and resume/CV), or in any oral statements I may make during the selection process shall be sufficient cause to end further consideration of my application prior to being hired, or shall be sufficient cause for disciplinary action up to and including termination, in the event I am hired; - The University will verify academic and professional credentials and may contact present and past employers to check professional references, as provided, either prior to or after receiving an offer of employment; - An offer of employment is contingent on successful completion of the entire employment selection process. Offers and terms of employment will only be made in writing. - No manager or representative of CUNY has the authority to make an offer of employment or to represent a condition of employment which is in violation of the bylaws, policies, or collective bargaining agreements governing employment at CUNY; and any representations that are contrary to these policies, even when made in writing, are unenforceable.
Date
Job ID# Full-time Part-time
No relatives Yes, I have (a) relative (s)
Yes No
Application for Employment - Part One (Employment and Educational History of the Applicant)
Applicants should submit this form at the time of the initial interview to the search committee.
Signature
College
CUNY EMPLOYMENT APPLICATION - PART ONE March 2016
Page 2 of 7
A. Education (Please indicate highest equivalent grade of education completed):
List schools attended, beginning with most recent (university, college, business school, vocational or trade school, high school, etc.)
School Name
Location
Major Study
Credits completed
Degree received
B. Employment History: Begin with present (or last job if currently unemployed) and work back for the last 15 years, listing all full or part-time employment. Be sure to include any current CUNY employment held. Attach additional pages, if necessary.
Degree received
Credits completed
Major Study
Location
School Name
Degree received
Credits completed
Major Study
Location
School Name
Doctorate Masters Baccalaureate Associate High School/GED Trade/Vocational School
Hourly
Gross WeeklyGross AnnualSalary (Indicate one):
Reason for leaving
Date employed to
Date employed from
Average hours worked per week part-time Part-time Full-time
Telephone
Name/Title of Immediate Supervisor
Telephone Briefly describe duties
Address
Job TitleEmployer Name
Degree received
Credits completed
Major Study
Location
School Name
Degree received
Credits completed
Major Study
Location
School Name
Degree received
Credits completed
Major Study
Location
School Name
IF REQUIRED FOR POSITION: Provide driver's license number, professional/trade license/certification numbers. Attach page, if necessary
Professional Degree
CUNY Contract Title, if applicable
Hourly
Gross WeeklyGross AnnualSalary (Indicate one):Average hours worked
per week part-time Part-time Full-time
Reason for leavingTelephone
Date employed to
Date employed from
Name/Title of Immediate Supervisor
Briefly describe duties
Telephone
CUNY Contract Title, if applicableAddress
Job TitleEmployer Name
CUNY EMPLOYMENT APPLICATION - PART ONE March 2016
Page 3 of 7
C. Important skills, competencies, or experience not identified above: Identify other important skills, competencies, expertise, or related experiences (such as volunteer work, competence in foreign language, etc.) that you feel should be considered in evaluating your suitability for this position. Attach additional pages, if necessary.
Hourly
Gross WeeklyGross AnnualSalary (Indicate one):Average hours worked
per week part-time Part-time Full-time
Reason for leavingTelephone
Date employed to
Date employed from
Name/Title of Immediate Supervisor
Briefly describe duties
Telephone
CUNY Contract Title, if applicableAddress
Job TitleEmployer Name
Hourly
Gross WeeklyGross AnnualSalary (Indicate one):Average hours worked
per week part-time Part-time Full-time
Reason for leavingTelephone
Date employed to
Date employed from
Name/Title of Immediate Supervisor
Briefly describe duties
Telephone
CUNY Contract Title, if applicableAddress
Job TitleEmployer Name
Have you ever left a position for any disciplinary reason? Yes No
If yes, explain briefly: Attach additional pages, if necessary
CUNY EMPLOYMENT APPLICATION - PART ONE March 2016
Page 4 of 7
G. How did you learn about this position? Check all that apply:
Other General Category (Please explain)
Search Firm
Social Media (LinkedIn, Facebook, Academia.edu, Other)
Professional or academic group, contact, or referral
Job Fair, Conference, or Convention
Government Job Bank or Resource Agency (Veterans' Vocational Rehabilitation, Other)
External Job Board
Printed Advertisement
Search Engine (Bing, Google)
Union office
Someone I know who works at CUNY
CUNY Website (cuny.edu or cuny.jobs)
College Website
College Human Resources Office
COLLEGE USE ONLY
Reviewed by Chair of Search Committee:
Name
Date
Title
e-mail e-mail e-mail
Daytime Phone #Daytime Phone #Daytime Phone #
AddressAddressAddress
Company Company Company
TitleTitle
3. Name2. Name1. Name
The University may conduct a background investigation including, but not limited to, contacting references that you provide. Please list a minimum of three persons who are not related to you and who have definite knowledge of your qualifications and fitness for the position for which you are applying. The Authorization to Release Reference Information Form (Page 7) must be completed.
D. Professional References:
Signature
CUNY EMPLOYMENT APPLICATION - PART ONE March 2016
Page 5 of 7
THIS PAGE INTENTIONALLY LEFT BLANK
I have applied for a position with The City University of New York (CUNY) and would like CUNY to be fully informed of my qualifications for the position. I hereby authorize any current or former employer, professional reference, and education/training provider, to disclose in good faith any information they may have regarding and pertaining to my qualifications and fitness for employment. I agree to hold such employers, references, educational/training institutions and any other persons giving references harmless from liability or damages for providing the requested information. A photocopy or fax of this authorization shall be as valid as the original.
Authorization to Release Reference Information
Position sought
Name of Candidate
CUNY encourages people with disabilities, minorities, veterans and women to apply. At CUNY, Italian Americans are also included among our protected groups. Applicants and employees will not be discriminated against on the basis of any legally protected category, including sexual orientation or gender identity.
CUNY is an EEO/AA/Vet/Disability Employer.
DateSignature
College
CUNY EMPLOYMENT APPLICATION - PART ONE March 2016
Page 7 of 7
Post-Conditional Offer Verifications and Checks
Employment Eligibility and Identity Documents Verification
Newly hired employees must complete Section 1 of the Dept. of Homeland Security/U.S. Citizenship & Immigration Services I-9 Form no later than the first day of employment. CUNY is required to verify evidence of identity and employment authorization within 3 business days of the employee's first day of employment. Verification of Credentials
Academic and professional credentials, as submitted in CUNY Employment Application Part 1, will be verified by the college. Criminal Background Check
As a candidate with a conditional offer of employment, you must provide criminal background information. For some positions, a criminal history report may also be required. CUNY will consider your criminal history in accordance with Article 23-A of the New York State Correction Law. A conviction record will not necessarily disqualify you from the position for which you are applying. However, failure to provide truthful responses will, when discovered, automatically result in the withdrawal of the conditional offer of employment or your termination, if employed. Before any adverse action is taken based on a previous criminal conviction, CUNY will - provide a written Article 23-A analysis to the candidate in a form determined by the New York City Commission on Human Rights (NYCCHR), together with any and all supporting information and/or documents which formed the basis and reasons for the adverse action; and - after providing the candidate with the required documentation, allow him or her at least three business days to respond and, during that time, hold the position open for the candidate.
Credit History Check, Medical Certification, Medical Examination, Drug Screening, and Physical Agility and Fitness
Assessment
For some positions, a credit history, medical certification, medical examination, drug test, and/or physical agility and fitness assessment may be required as a condition of employment. CUNY processes all information per applicable laws. Accommodation required to perform Essential Job Functions
It is the University's policy to provide reasonable accommodations, when appropriate, to individuals with disabilities, individuals observing religious practices, employees who have pregnancy or child-birth related medical conditions, or employees who are victims of domestic violence/stalking/sex offenses. If you require an accommodation to perform the essential job functions for the position for which you have received a conditional offer of employment, please contact the HR Director at the college or unit where you have received the conditional offer of employment.
THE CITY UNIVERSITY OF NEW YORK EMPLOYMENT APPLICATION - PART TWO
POST-CONDITIONAL OFFER OF EMPLOYMENT
This form should be completed only after a conditional job offer has been made.
Name
Position
CUNY EMPLOYMENT APPLICATION - PART TWO September 2016
Page 1 of 3
Dept.
College
THE CITY UNIVERSITY OF NEW YORK
APPLICATION FOR EMPLOYMENT - PART TWO
Position
Contract Title
Last Name
P.M.
A.M.
Personal Information
First Name Middle Initial
If known by another name, please provide
Address
City State Zip Code
Apt. #
Daytime Phone #
Evening Phone #e-mail
Job ID# Full-time
Part-time
Application for Employment - Part Two (Confidential Background Information)
Only candidates who have received a conditional job offer should complete this form.
For questions and concerns, candidates may request guidance from the Office of Human Resources.
The completed form should be submitted to the Office of Human Resources only.
Please complete Page 3
College
CUNY EMPLOYMENT APPLICATION - PART TWO September 2016
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3. Please explain below all past convictions or currently pending criminal charges against you (as specified in Questions 1 and 2 above). Attach additional pages, as necessary.
2. Are there any criminal charges currently pending against you?
No
1. Have you ever been convicted of a misdemeanor or felony? Even if you were convicted, answer "NO" if your conviction: (a) was sealed, expunged, or reversed on appeal; (b) was for a violation, infraction, or other petty offense such as "disorderly conduct"; (c) resulted in a youthful offender or juvenile delinquency finding; or (d) if you withdrew your plea after completing a court program and were not convicted of a misdemeanor or felony.
Yes
No Yes
Disposition including incarceration
Name and location of Court
Date of conviction
Offense
Disposition including incarceration
Name and location of Court
Date of convictionOffense
Disposition including incarceration
Name and location of Court
Date of convictionOffense
Disposition including incarceration
Name and location of Court
Date of conviction
Offense
COLLEGE USE ONLY
Received by the Director of Human Resources
Name Date
Confidential Criminal Background Information:
Date
Applicant Attestation: By my signature below, I declare and affirm that I have read and fully understand that: Any misrepresentation or material omission of facts on this form shall be sufficient cause to end further consideration of my candidacy for the position for which I have received a conditional offer of employment or shall be sufficient cause for disciplinary action up to and including termination, in the event I am hired.
Signature
Signature
CUNY EMPLOYMENT APPLICATION - PART TWO September 2016
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New Hire Account Request Form
Your OFFICIAL NAME must be used on this form. Please PRINT or TYPE all information.
Personal Information
Full Name:
Last First M.I.
DOB: Last 4 SSN:
Job Information
Job Title: Department:
Department’s Ext.: Employee ID:
New/ Old Ext. Line: Room # :
Hired By BMCC....………….. [ ] Research Found…………. [ ]
Position/Function Full Time………….. [ ] Part Time…………. [ ]
New Account (s) Computer…………………… [ ] Email…………….... [ ] Phone/Voicemail………… [ ] Copy/Print………… [ ]
Room Acs/Keys
Comments:
Approval
Please provide ONE signature of approval before returning This Form to the Help Desk, Room S-141
Vice-president:
Last First Date Signature
Director/Manager:
Last First Date Signature
Chairperson:
Last First Date Signature
Any missing or unclear information will result in a delay in the process.
OFFICE USE ONLY
Date Received: AD/Email Copy/Print Access/Keys
Received By:
Date Completed: Telephony Web Directory Others
Completed By:
Report of External Employment for Classified Staff
1
Employee/Candidate: Please complete sections A‐D regarding your CUNY employment and external
employment, both full‐time and part‐time. Carefully read the attestation in section E and sign the bottom.
Once it has been completed and signed, please submit this to the Human Resources Department of the CUNY
College at which you are primarily employed or to which you have applied.
All Information on this form is subject to verification. Please be advised that you are required to resubmit this
form with updates if there are any changes to your external employment.
A. Employee Information
Employee Name:
Date Completed
B. CUNY Primary Position
Title:
College: Department:
Regular Work Schedule Number of Hours per
Week Date of Appointment
CUNY Secondary Position
Title:
College: Department:
Regular Work Schedule Number of Hours per
Week Date of Appointment
2
C. External Employment
Employer:
Address:
Telephone & Fax Numbers:
Job Title:
Department:
Supervisor Name & Title:
Regular Work Schedule Number of Hours per Week Date of Appointment
D. No External Employment
___ I have no external employment. I understand that if I plan to obtain external employment, I must contact the HR Department of my school and submit an updated “Report of External Employment of Classified Staff” form BEFORE I begin the external employment.
E. Employee Attestation
By my signature below, I declare and affirm that the information submitted above is true and complete. I acknowledge that my full-time position at CUNY is my primary employment. I understand that may misrepresentation or material omission of facts in this form shall be a sufficient basis for ending further consideration of my application, or, in the event I have already been hired, shall constitute sufficient cause for disciplinary action, which may result in a penalty up to and including termination of employment. Signature Date
3
Sections E & F & G are for Office Use Only
F. Supervisor/Department Head Approval
____ Approve: I have reviewed this employee’s CUNY employment and his/her competed External Employment form and have determined that there is no conflict of interest between the two positions and that the situation is in compliance with CUNY’s policy regarding external employment.
____ Do Not Approve: I have reviewed this employee’s CUNY employment and his/her competed External Employment form and have determined that this situation is NOT in compliance with CUNY’s policy regarding external employment for the following reason(s):
___ there is a conflict of interest between the two positions
___ there is an overlap in scheduled work hours
___ there is not adequate time allocated for travel between the positions. Comments:
Signature Date Print Name Title G. Human Resources Director Approval: ____ Approve: I have reviewed this employee’s CUNY employment and his/her competed External
Employment form and have determined that there is no conflict of interest between the two positions and that the situation is in compliance with CUNY’s policy regarding external employment.
____ Do Not Approve: I have reviewed this employee’s CUNY employment and his/her competed External Employment form and have determined that this situation is NOT in compliance with CUNY’s policy regarding external employment for the following reason(s):
___ there is a conflict of interest between the two positions
___ there is an overlap in scheduled work hours
___ there is not adequate time allocated for travel between the positions.
Comments: Signature Date Print Name Title
4
H. Presidential Approval for External Full-Time Positions:
____ Approve: I have reviewed this employee’s CUNY employment and his/her competed External Employment form and have determined that there is no conflict of interest between the two positions and that the situation is in compliance with CUNY’s policy regarding external employment.
____ Do Not Approve: I have reviewed this employee’s CUNY employment and his/her competed External Employment form and have determined that this situation is NOT in compliance with CUNY’s policy regarding external employment for the following reason(s):
___ there is a conflict of interest between the two positions
___ there is an overlap in scheduled work hours
___ there is not adequate time allocated for travel between the positions. Comments: Signature Date Print Name Please return to the HR Director Retain original document in employee file
CHECKLIST FOR NEW COLLEGE ASSISTANTS
-A few important timesheet related notes
Pay is based on total weekly hours scheduled to work provided you work these hours and submit time sheet for every week you work. Any missing information on the timesheets must be initialed by your supervisor to get paid for that particular day. You cannot exceed the total number of hours you are scheduled to work.
o Timesheets will not be processed if they are missing names, dates, or signatures.
If your supervisor deems it necessary for you to work a different schedule for one particular week, an e-mail must be sent up to HR by your supervisor, to your time keeper, indicating the change in schedule at least one week before the change takes place. Additionally, it must be noted on the bottom half of the time sheet and signed/initialed by your supervisor.
You do not get paid for holidays. However, you can charge a holiday to annual leave provided you have time available.
You do not get paid for annual leave or sick leave until you accumulate 500 hours of work (per fiscal year).
Once you reach 500 hours you can begin to use annual leave and sick leave hours. Fill out a leave request form and, if possible, write on the time sheet itself which date(s) you want annual or sick leave time to be used.
o Annual leave hours are accrued at the rate of 1 hour for every 15 hours worked.
o Sick leave hours are accrued at the rate of 1 hour for every 20 hours worked. (A doctor’s note should be brought in at all times, but it must be brought in when absent from work for 3 or more consecutive days and using sick time before or after a holiday (or else you cannot use sick time for that day, even if you have time available.)
A lunch break is deducted whether used or not. Time for a break is earned as follows.
o A college assistant working more than five but less than 6 hours (5-6) earn a half hour lunch break.
o A college assistant working 6 hours or more earns an hour lunch break.
Lateness is deducted based on the lateness policy. (see Explanation of Benefits for a breakout of the lateness
penalties)
Discuss any questions about your timesheet and/or hours worked first with your supervisor. Many problems can be alleviated simply by looking at your timesheet and discussing it with your supervisor. Any further questions regarding your hours worked for a given week can be referred to your timekeeper as follows: One final note: please keep all your pay stubs as we do not have copies of these stubs. Bring your pay stubs with you if you have any questions. If you have direct deposit, your pay will be deposited into your account of Friday. If you do not have direct deposit, you may pick up your check at the Bursar’s office (3rd floor windows) after 3 pm on the Thursday.
Benefits Available for College Assistants And Hourly Employees
HEALTH BENEFITS College Assistants/tutors are eligible for benefits once they have completed 90 days of employment and have continuously worked 20 or more hours a week during that time period. As long as the forms are completed and handed in within 90 days, the effective date of coverage is on the 91st day of employment. Otherwise it will be effective the next payroll cycle, after the forms has been submitted. There is no cost for basic coverage for some of the health plans offered through the City Health Benefits Program. Others require a payroll deduction. Health Benefit applications and rate sheets are available at http://www.nyc.gov/olr, or the Benefits Office, room S717. City paid health plan coverage continues only for the period that you meet the criteria mentioned above. If for any reason you no longer meet the eligibility requirements for City paid coverage, you may elect to continue your health plan coverage through COBRA at full cost plus administrative fees. Please notify Human Resources if you fall under this category. UNION BENEFITS If you work 17 ½ hours or more a week and have completed and sent in a DC 37 Health & Security enrollment card, you will be eligible to receive union welfare benefits. Local 2054 of District Council 37, the Union that represents College Assistants, offers a fringe benefits package and tuition reimbursement program. For further details contact the Union at 125 Barclay Street, New York, NY 10007, (212) 815-1234. Or Local 237 members for Campus Security Assistants (Hourly) 212-924-2000. AGENCY FEE SHOP Under an act passed by the New York State Legislature and by agreement between City and Municipal employee unions, employees in the title of College Assistant who are represented in collective bargaining and who are union members are subject to a deduction from their salary in an amount equal to the dues payable by a union member. This deduction is called agency shop fee and it is listed on your paycheck as District Co 37 Loc 2054 A/S. However, College Assistants who regularly work 12 hours or fewer a week may apply for a quarterly refund for the agency shop fee by submitting a completed worksheet with copies of pay stubs to the DC-37 Accounting Office at 125 Barclay St.-Room 501 New Your, NY 10007 ATTN Henderson Davis. Worksheets are in available the Human Resources Department and at DC 37. JURY DUTY Employees summoned to Jury Duty in New York State/New York State Courts are eligible to be paid the current juror fee for the first three days if they are scheduled to work and earn more than the fee. If employees are not scheduled to work, they will not be paid.
Updated October 2016
PENSION New York City Employees’ Retirement System (NYCERS) is a defined plan. Benefits are based on age, average salary and years of employment. Employee’s contribution is based on salary.
Annual Wages Earned During Plan Year Contribution Rate Up to $45,000 3% $45,001 to $55,000 3.5% $55, 001 to $75,000 4.5% $75,001 to $100,000 5.75% Greater than $100,000 6%
The vesting period is 10 years of Credited Service. Tier 6 Basic Plan members must contribute until they separate from City service or until retirement. Full retirement age is 63, to collect an unreduced Service Retirement Benefit. The City contributes a lump sum annual to the pension funds. TAX DEFERRED ANNUITY This plan allows participants to defer a percentage of salary before taxes through a salary reduction from your paycheck. TIAA offers a Tax Deferred Annuity Program, please contact: Mr. Narcisse Dargenson at 212-916-5155; OR the New York City Deferred Compensation Plan. For information call 212-306-7760. NEW YORK STATE DEFERRED COMPENSATION PROGRAM – 457 PLAN You may join this plan in addition to participating in the tax deferred annuity. For enrollment information please contact: Brandon Herlihy, account executive at 1-800-422-8463 ext. 8544547. TRANSIT BENEFIT The transit benefit program allows employees to save on transportation expenses through pre-tax payroll deductions. For information and enrollment go to http://www.cuny.edu/transitbenefit DIRECT DEPOSIT If you wish to have your check direct deposited into your bank account, please complete application and provide documentation e.g., checking account a void check or savings a copy of first page of statement from bank. CUNY WORK/LIFE PROGRAM This employee assistance program is a voluntary, free and confidential benefit for employees and their family members. Services are available 24 hours a day, 7 days a week. For additional information, please call 1-855-492-3633 or visit the CUNY Work/Life Program website at www.deeroaks.com. To log in use Company Code: BMCC Password: BMCC
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