Benefit Change Form - CLICK HERE to ENROLL ON-LINE (form will be submitted electronically). Print the paper enrollment form (CLICK HERE to download and print; return completed form to the Dept. of HR, Benefits in WAB G-25)

Dependant Care FSA Acknowledgement Form - Provide this form to your DayCare provider to certify your childcare costs

Emergency Travel Assistance Brochure - Print this brochure and take along with you when traveling in the event you need emergency assistance

Evidence of Insurability Form - Use this form to complete the statement of health for life insurance requests over the guarantee issue amount

Short Term Disability Claim Packet - Use this form to apply for benefits under the Short Term Disability Policy

Long Term Disability Claim Packet - Use this form to apply for benefits under the Long Term Disability Policy

Medical FSA Reimbursement Request Form - Use this form to send in receipts to FlexCorp to apply for reimbursement under the medical flexible spending account.

Eligibility Determination Form for Shared Medical Leave

Medical Leave Bank Donor Form

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Tuition Waiver Form for Employees

Tuition Waiver Form for Employees
Attending Other KY Institutions
DO NOT USE IF YOU ARE A WKU STUDENT!!!

Tuition Discount Form for Dependent Children

Tuition Discount Form for Spouses of Employees
Tuition Discount Form for Part-Time Faculty