Benefits

FMLA Request (12 Month) Purpose: Use this form to request authorization for extended leave under the Family Medical Leave Act (FMLA) – 12 month employees. Email Contact: benefits@charlotte.edu Last Updated: July 26, 2024

Fitness for Duty Certification Purpose: Use this form to provide verification of ‘fitness for duty’ when an employee has received medical authorization to return to work (with or without work restrictions). Email Contact: benefits@charlotte.edu Last Updated: July 25, 2024

Emergency Loan Fund Request Purpose: Use this form to request a loan from the Emergency Loan Fund ($100 to $250 once per year). Email Contact: employee-relations@charlotte.edu Last Updated: July 25, 2024

ComPsych Authorization Request – Employee Assistance Purpose: Use this form to request authorization for participation in the Employee Assistance Program (ComPsych). Email Contact: employee-relations@charlotte.edu Last Updated: July 25, 2024

Beneficiary Designation (TSERS Retirement) Purpose: Use this form to request employee beneficiary information addition(s) and/or update(s) associated with the Teacher’s and State Employee Retirement plan (TSERS). Contact Email: benefits@charlotte.edu Last Updated: July 22, 2024

Academic Assistance Request Purpose: Use this form to request reimbursement for academic course work directly related to position role assigned. Contact Email: hrtraining@webmaster Last Updated: July 25, 2024