FACULTY/STAFF Fill-in Forms

A - B - C - D - E - F - G - H - I - J - K - L - M - N - O - P - Q - R - S - T - U - V - W - X - Y - Z


Fill-in Forms make it possible for you to enter information while the form is displayed through Word or Acrobat Reader.  You can the print and file your completed form or attach to an e-mail message.  PDF formatted documents contain the same text as the original printed documents.  To view PDF formatted documents, you must have Acrobat Reader, which is available free from Adobe.  Click the link to download the latest version of Acrobat Reader.  Please review Completing a Fill-in Form for detailed instructions on usage.  To save the fill-in formation with the form, use the Word version.  Acrobat Reader will not allow the information to be saved.

*If you are experiencing an issue with a fill-in form, please contact smithk@faytechcc.edu.  The IEA staff will make contact with you about your request within 24 working hours of receipt of your message.

Forms created in "Excel" format are identified

A

FTCC Form #

Word

Acrobat Reader

Absence, Report of

A-1

doc pdf
Academic Agreement Review Checklist

 A-14

doc   pdf
Academic Probation or Suspension Status

 A-17

 doc  pdf
Academic Program Approval

 A-21

 doc  pdf
Accident/Medical Incident Report, Request for Security (Security)

A-7

 N/A  pdf
Accommodation Request (Special Populations)

A-36

 doc  pdf
Acquired Property Evidence Tag, Request for Security (Security)

A-8

 N/A  pdf
Active Directory/Groupwise User Form, FTCC

A-13

doc  pdf 
Additional Residency Information, Request for

A-31

 doc  pdf
Administrator Evaluation (Appendix F)

A-3

N/A   pdf
Advance Payment, Request for (VA Office)

A-4 

doc pdf
Advisory Committee Member Information

A-34

doc  pdf 
Advisory Committee Selection of Officers

A-35

 doc pdf
Affidavit of Support (I-134)

A-16

N/A   pdf
Altercation Statement (Security)

A-10

 doc  pdf
Annual Departmental Evaluation of Library Collection

A-5

 doc  pdf
Annual Departmental Review for Academic Year Fall 2011-Spring 2012

A-26

 doc  pdf
Annual Program Review AA, AGE, AS Programs Only

A-29

doc   pdf
Annual Program Review for Academic Year Fall 2011-Spring 2012

A-28

doc pdf
Application for General Admission (For Faculty and Staff only)

A-19 

doc  N/A
Ask A Question:  Counseling

A-32

 N/A  pdf
Assistance Authorization Card, Request for Security (Security)

A-9

 N/A  pdf
Assistance from Security, Request for (Security)

A-11

 doc  pdf
Audit Form

A-6

 N/A  pdf
B FTCC Form # TOP

Background Criminal Convictions Report and Authorization Form

B-2 doc pdf

Bomb Threat Checklist (Security)

B-1 N/A  pdf 

Bomb Threat Evaluation Sheet (Security)

B-3  doc  pdf

C

     

Central Supplies, Requisition for

C-48  Excel N/A 

Certificate of Achievement (Security)

C-18 

 N/A  pdf

Chain of Custody Receipt HEC (Security)

C-19 

 Excel  pdf

Chain of Custody Receipt SLC (Security)

C-20  Excel  pdf

Change Academic Program Approval Form

C-42  doc pdf 

Check Points Blue HEC, Request for Security (Security)

C-11

 N/A  pdf

Check Points Chip, Request for Security (Security)

C-12 

N/A   pdf

Check Points Green SLC, Request for Security (Security)

C-13 

 N/A  pdf

Check Points Red, Request for Security (Security)

C-14 

 N/A pdf 

Check Points Yellow, Request for Security (Security)

C-15 

N/A pdf 

CPL Equivalency Approval Form

C-23 

doc   pdf

Code of Ethical Conduct

C-2  doc  pdf

College Assembly Report Recommendations/Response

C-3 

 doc  pdf

Community Service Leave Approval

C-39 doc  pdf 

Competency Form, Evidence of (Form J)

C-4  doc  pdf

Consent for Release of Student Information (FERPA)

C-49 

 doc pdf 

Consent to Release Confidential Information (Workforce)

C-24 

doc   N/A

Construction and Renovation Project Approval Form

C-21 

 doc pdf 

Continuing Education Student Registration Form

C-22 

N/A  pdf

Continuing Education Unit Course Approval Form

C-43 

doc   pdf

Contract Request (Part-time)

C-6 

 N/A  pdf

Counseling Services Referral Form

C-50  doc  pdf

Course Approval for Employees, Request for

C-5 

 doc  pdf

Course Repeat Request, First & Second Attempt

C-36 

 doc  pdf

Course Repeat Request, Third Attempt

C-8 

 doc  pdf

Course Review Checklist - Online Courses & Hybrid

C-40  doc  pdf

Course Substitution Form

C-9 

 doc  pdf

Courtesy Card, Request for Security (Security)

C-16 

N/A   pdf

Credit for Prior Learning Effective Online Teaching

C-10 

doc   pdf

Cross Divisional Employment Approval

C-7 

 doc  pdf

Curriculum/Course Change Application Packet

C-41  doc pdf 

Curriculum Program Dean Overrides

C-37 

 doc  pdf

Customer Survey, Request for Security (Security)

C-17 

 N/A pdf 
D FTCC Form # TOP
Development Dimensions International (DDI) Targeted Selection Interviewing Workshop Registration Form

 D-10

doc N/A
Directed Studies Agreement Form

D-9 

 doc pdf 
Disability Disclosure, Individual

D-1 

doc pdf 
Discrimination/Harassment Complaint Form

D-8 

 doc  pdf
Disposal of Surplus and/or Obsolete Equipment

D-2 

 doc  pdf
Dissolve a Student Club or Organization, Request to

D-13 

doc   pdf
Document Control Routing Form (Blue Form)

D-11 

 doc N/A
Drug and Alcohol Prevention Program

D-3 

doc   pdf
Duress Alarm/Emergency Call box, Request for Security (Security)

D-5 

 N/A

 pdf
E FTCC Form #

TOP 

Election Results Memorandum for Record

E-7 

 doc

pdf 

Emergency Information, Request for Security (Security)

E-16 

 N/A

 pdf

Employee Laptop Assignment Agreement

E-17 

 doc

 pdf

Employee Information

E-20 

 doc

 pdf

Employee Performance Appraisal

E-32 

doc 

 pdf

Employer Job Posting Form/Students and Alumni Jobs

E-9

doc

pdf

Employment Approval Form, Secondary 

E-2 

doc 

 pdf

Employment Guidelines (Security)

E-19 

 doc

 pdf

Employment, Full-Time (Form A)

E-3 

doc 

N/A

Employment, Part-Time (Form A-1)

E-4 

 doc

N/A

End of Year Report Form

E-29 

 doc

 pdf

End of Year Report On Institutional Critical Success Factors

E-30 

 doc

 pdf

Equipment Decision Package Form E-5

 doc

 pdf

Equipment/Personnel Critical Needs

E-6 

 doc

pdf 

Equipment Transfer Form

E-34 

 doc

 pdf

Equal Employment Opportunity Statement

E-18 

doc 

pdf 

Equipment/Uniforms Issued (Security)

E-21 

 Excel

pdf 

Equipment, Request for E-28

doc 

pdf 

Evaluation, Educational Degree & Work Experience (Form F)

E-26 

doc 

pdf 

Exit Forms - Exit Checkout

E-13 

 doc

 pdf

Exit Forms - Exit Questionnaire

E-14 

doc 

pdf 

Expense Decision Package Form, Other Operating E-15

doc 

 pdf

F

FTCC Form #

TOP

Facilities Critical Needs

F-1 

doc  pdf 

Facilities Decision Package Form

F-2 

doc   pdf
Facility/Staff Move, Request For

F-11 

 Excel N/A 

Facility Naming Recommendation Form

F-3

doc  pdf
Facility Request Form

F-13 

 doc  pdf
Facilities Inspection Checklist

F-24

 doc  pdf
Fact Book Survey - How Did We Do?...

F-15

N/A  pdf

Faculty Credentials Form: Alternative Qualification Summary Sheet

F-14 

 doc  pdf
Faculty Online Teaching Observation F-19  doc  pdf
Faculty Suggested Titles for Addition to Library's Collection

F-22 

 doc pdf 
Faculty Teaching Observation

F-17 

doc   pdf
Faculty Workload Adjustments Approval Form

F-16 

 doc pdf

FAX Cover Sheet

F-4 N/A   pdf
Fay Tech NOW Assessment F-21 N/A  pdf 

Field Interviews, Request for Security (Security)

F-5

N/A  pdf

Field Trip, Request for

F-7 doc   pdf

Fire Drill Evaluation Sheet (Security)

F-6 Excel   pdf
First Aid Supplies, Request for (Security)

F-18

doc   pdf
F1 Student Responsibility Agreement

F-23

 doc  pdf
G

FTCC Form #

TOP
Getting Help: Counseling

G-6

 N/A  pdf
GPA Confirmation Form

G-5

 doc  pdf
Grade Change Request Form

G-1

 doc  N/A
Grade Forgiveness, Request for

G-8 

doc N/A
Graduation Fee Refund, Request for

G-4 

doc  pdf
Grant Funding, Request for

G-2 

doc  N/A
Guest Lecturer Notification Form G-3 doc  pdf
  H

 FTCC Form #

TOP  
Hazardous Chemical Inventory Disposal Form

H-6

doc pdf
Health Audit Appeal Form

H-5

 doc pdf
Health Program Readmission Form

H-4 

doc  pdf
Hepatitis B Form (Security)

H-2 

 doc pdf
High School Connections Form

H-3

 N/A  pdf
Honorary Trustee Nomination Form

H-1 

doc  pdf
  I

 FTCC Form #

TOP  

Identification Data Form, Request for Security (Security)

I-7

 doc pdf

Improvements, FTCC

 I-1

 doc pdf

Incident Report, Request for Security (Security)

I-4  N/A  pdf

Instructional Textbook(s), Request for

I-2 

doc pdf
Intake Form, Student (Special Populations) I-18  doc  pdf
Interlibrary Loan (OCLC) Book Request I-11  doc  pdf
International (F1) Application for Admission I-9  doc  pdf
International Student Financial Certificate I-10  doc  pdf
Interview Approval Form

I-3 

 doc N/A
Interview Guide

I-12 

 doc N/A
Interview Guide Supplement I-14  doc N/A
Interview Question/Target Rating Consensus Sheet

I-13 

 doc  N/A
ISA Agreement

I-5 

 doc  pdf
  J

 FTCC Form #

TOP  
 

 

   
  K

 FTCC Form #

TOP  
Key/Access Card Approval Form, Part-Time Employee

 K-1

doc pdf
  L

FTCC Form # 

 TOP 

Larceny Report, Request for Security (Security)

L-6 

 N/A  pdf
Leave, Donation of Voluntary Shared

L-1 

 doc  pdf

Leave, Request for (Security)

L-9 

Excel  pdf

Leave, Request for Family Medical

L-2

doc  pdf
Leave, Request for Voluntary Shared L-4  doc  pdf
Library Orientation Quiz (Version 1) L-5 doc   pdf
Library Orientation Request L-20  doc  pdf
Library PO L-21  N/A  pdf
Lockout/Tagout Periodic Inspection

L-16 

 doc  pdf
Loss or Theft of Equipment

L-18

 doc  pdf

Lost and Found Property Log (Security)

L-8

 N/A pdf 

Lost and Found Slip, Request for Security (Security)

L-7

 doc pdf 
  M

FTCC Form # 

TOP  
Media Services Request Form

M-6

Submit Electronically
Meeting Agenda Form

M-8

 doc N/A 
Meeting Minutes Form

M-9

 doc  N/A
Merit Increase, Request for

M-1

 doc pdf 
Military Tuition Waiver Form

M-7

doc   pdf
Mini-Grant Application 2013-2014

M-5 

N/A pdf
Mitigating Circumstances, Report of

M-4 

 doc pdf
Model Release Form

M-10

doc  pdf 

Monthly Activity Report Form (Security)

M-3

 Excel  pdf
Motor Vehicle Request Form

M-11

 doc  pdf
  N

FTCC Form #

TOP  
NC-4 EZ

N-11

N/A pdf
NC-4 Tax Form

N-10

 N/A  pdf
New Employee Authorization for Direct Deposits

N-8

 doc  pdf
New Employee Personnel Data Form

N-5

doc pdf 

New Employee Viewed Training Tapes 1 (Security)

N-2 

doc  pdf 

New Employee Viewed Training Tapes 2 (Security)

N-3

 doc  pdf

New Hire Processing Checklist (Security)

N-4 

 doc  pdf

New Part-Time Faculty Employment Checklist

N-6

 doc  pdf

New VA Student Checklist

N-1

 doc  pdf
 

 

   
  O

FTCC Form # 

TOP  

Off Cycle Class Schedule

O-8

doc   pdf
Excel

Officer Training Agenda (Security)

O-3

 Excel pdf
Online Blackboard Course Development Proposal

O-9

doc  pdf
Online Faculty Email Account Form, FTCC

O-10 

 doc pdf

Other Critical Needs

O-1

 doc pdf
  P

FTCC Form # 

TOP  
Parent Information

P-19 

 doc  pdf

Parking Permit, Request for Security (Security)

P-5

 N/A pdf 
Part-time Employee Personnel Data Entry P-22 doc  pdf
Part-time Employee Personnel  (Continuing Education) P-15  doc  pdf
Part-time Hourly Time Report

P-3

N/A Excel
PAS Assessment P-10  doc  pdf
Performance Improvement Plan

P-24

 doc  pdf
Petition/Recognition for a Student Club or Organization P-6 doc  pdf 
Post 9/11 GI Bill-Chapter 33 (Veteran Services) P-7 doc   pdf
Pre-Entrance Medical Record for International Student P-11 doc pdf 
Preliminary Application for Foreign Student Admission

P-12

 doc pdf 
Printing & Duplicating, Request for

P-2 

 doc  pdf
Professional Development Blank Survey

P-8 

doc  pdf 
Professional Development (Employee) P-14  doc  pdf
Professional Development Sign-in Roster P-20  doc  pdf
Professional Development Waiver Form, Faculty

P-25 

 doc  pdf
Professional Services Agreement P-16  doc  pdf
Professional Services Agreement Billing Form P-18  doc  pdf

Proficiency Grade Form

P-4 

doc  pdf 

Program Review

 P-1

doc  -

President's Award Nomination Form

P-26 

 doc pdf 

Q

FTCC Form # 

 TOP 
 No Form at this time     
R

 FTCC Form #

TOP  

Record of Counseling (Security)

R-3 

 doc  pdf

Registration Change Notice

R-15 

N/A  pdf
Reinstatement Request Form

R-17

 doc pdf 
Report of Absence (PT Curriculum Faculty)

R-1

 N/A pdf 

Release of Information (Security)

R-4

 doc  pdf

Report Statement Continuation Sheet, Request for Security (Security)

R-2

 N/A pdf 

Request for Virtual Office Hours

R-18 

 doc pdf 

Residency Appeal Application

R-16 

doc   pdf

Rose Garden Reservation Form

R-11

 doc  pdf
S

FTCC Form # 

TOP  
Salary Decision Package Form

S-1 

 doc  pdf
Security Daily Log Entries (Security)

S-25 

doc  pdf 
Security Daily Log Continuation Sheet (Security)

S-24

 doc  pdf

Second Degree Trespass Warning, Request for Security (Security)

S-15 

 N/A  pdf
Security Checks (Security)

S-21 

 doc  pdf

Security Duty Schedule (Security)

S-14 

 Excel  pdf
Sexual Harassment Policy

S-5 

doc pdf 
Special Populations Test Instructions

S-13 

 doc  pdf

Statement of Witness, Request for Security (Security)

S-16 N/A  pdf 

Strategic Plan Form

S-8

 doc  pdf

Strategic Prioritization List Form

S-9 

 doc  pdf

Student Activities, Request for Approval of

S-10 

 doc pdf 

Student Assistance Program Referral

S-17

 doc  pdf

Student Data Change Form (Address)

S-37

N/A   pdf

Student Notification of Excused Absence for Religious or Solemn Observance

S-41 doc   pdf

Student Probation Form

S-20

 doc  pdf

Student Retention Tracking

S-22

 doc  pdf

Student Suspension Appeal for Re-Admission

S-7 doc   pdf

Student Tuition/Fee Appeal Form

S-31  doc pdf 

Success Center Course Instructor's Referral Form

S-38 N/A pdf 

Supervisor's Accident  Report (Security)

S-6

 doc N/A

Supervisor Feedback Form

S-39  doc pdf 

Supplies, Request for

S-11

doc  pdf

Supplemental Instruction Referral Form - Health Programs

S-3

 N/A pdf 

Survey Authorization Form

S-12 doc   pdf
Syllabus S-19 doc   N/A
  T

FTCC Form # 

TOP  
Telephone/Written Reference Check (Form G)

T-1 

 doc pdf 
Temporary Employment Agreement

T-12 

 N/A  pdf

Time Report, Employee's Daily and Monthly (New Version with Datatel Person #)

T-2  Excel N/A 
Time Report, Instructor's Daily and Monthly T-22  Excel  pdf
Time Sheet, Temporary Off Campus (Work-study)

T-26

 Excel pdf 
Time Sheet, Temporary On Campus (Work-study) T-27  Excel pdf 

Traffic Appeal (Security)

T-10

doc  pdf 
Training Checklist, New Administrator

T-29 

doc   pdf
Transcripts, Request for Continuing Education

T-21

 N/A  pdf
Transcript Request, Curriculum

T-18 

 doc  pdf
Transcript Request, Unofficial Curriculum T-19  doc  pdf

Transcript(s)/GED Request Form

T-17

 doc  pdf
Transfer Form for International Students T-11  doc  pdf

Transmittal Sheet (Blank)

T-15

 doc pdf 

Travel Advance Worksheet, Estimated

T-3 doc   pdf

Travel Authorization, Blanket

T-4

 doc  pdf

Travel (Local) Daily Log (State Funds)

T-5 doc    pdf

Travel, Request for

T-6  doc  pdf

Travel Reimbursement, Request for

T-7 doc   N/A

Tuition Free Course Form

T-8

 doc  pdf

Tuition Reimbursement, Request for

T-9  doc  pdf
Tuition for Family Members Moving to NC Due to Employment, Instate

T-24

 doc pdf 
Tuition Waiver Form For Tuition Paid By Employer T-23  doc pdf 
U

FTCC Form # 

TOP  
 No Forms at this time

 

  
  V

FTCC Form # 

TOP  

Vehicle, Request for Security Pickup (Security)

V-1

 N/A pdf

Vehicle Accident Report, Request for Security (Security)

V-2

 N/A pdf

Vehicle Checklist, Request for Security (Security)

V-3 

 N/A pdf
Verification of Performance of Contract

V-8

 doc pdf
Visiting Student Letter

V-7

doc  pdf
Visiting Student Permission to Register for Another College

 V-9

 doc pdf

W

FTCC Form # 

TOP
W-4 Form(2014) Tax Form

W-4

 N/A pdf

Warning Traffic Notice, Request for Security (Security)

W-1

 N/A  pdf

Work-Based Learning (WBL) Students Measurable Learning Objectives (MLOs)

W-11

doc pdf

Work-Based Learning (WBL) Application (Previously Co-Op)

W-8

doc pdf
Work-Based Learning , Employer Request for a Student (Previously Co-Op) W-7 doc pdf
Worksheet, Placed Student Information (Work-Based Learning) W-10 doc pdf

Workforce Development Board Request for Reimbursement for Program Services

W-9 Excel N/A
Workforce Development Staff Leave of Absence Request

W-3

 doc pdf
Workforce Development Center Worksite Request

W-5

 doc  pdf
Work-Study Allowance, Application for (VA Office)

W-6 

N/A pdf
Wrecker Service Log (Security)

W-2

 Excel  pdf
 X

FTCC Form # 

TOP 
 No Forms at this time

 

  

 FTCC Form #

TOP   
Yearly Activity Report (Security)

Y-1 

  Excel pdf
Z

FTCC Form # 

TOP   
 No Forms at this time