Forms Repository | Pierpont C&TC


Forms Repository


This institutional forms repository is organized according users (Faculty/Staff; Students; or Public). The Faculty & Staff portion of the page is organized alphabetically according to departments. Within an office the forms are organized alphabetically by form name. The Student section of the page is organized so that (hopefully) the more commonly used forms for students are listed first.

The forms available are in a variety of program types. If the document type is specified as a 'Form', then the link takes you to a document that is electronically fill able, but not editable in any other way. In time, help documents will be developed to assist users with using the various form types. Eventually, we intend to develop the forms page so that the users can filter out only the forms that they might need, based on Institution, User type, Department, and even Form Name. *|PDF Form|Word Form|Drupal Form|HTML Form|Excel Form

If you have any forms to add or update, please contact the webmaster.

To skip to a specific section, click on the name.

Faculty/Staff Forms


Students Forms

  Academic Affairs     Admissions
  Bookstore     Financial Aid/Scholarships
  Business Office     Registrar
  Copy Center     Fairmont State University
  Facilities & Capital Projects (Physical Plant)     Pierpont Community & Technical College
  Faculty & Staff Awards and
Foundation Grants
    Workforce Development/
Off-Campus Programs
  Fine Arts      
  Human Resources     Student Affairs - Campus Life
  Information Technology     Student Affairs - Student Services
  Leadership Marion     Student Affairs - Student Activities
  Learning Technologies Center  

Public Forms

  Libraries     Pierpont Foundation Giving Opportunities
  Miscellaneous     GEAR UP
  Public Relations & Marketing     Public Safety
  Sponsored Grants Accounting      

**To open the PDF forms, you must have Adobe Reader

Academic Affairs (aa) (In most cases there are different forms for PCTC and FSU)


Bookstore (bk)

Cap and Gown Order Form |On-line Form (contact: Patti Miller)
Course Book Information Request |HTML (contact: Shelley Fox)
Course Pack Order Form |Docx (contact: Shelley Fox)
Publisher Information Form|PDF (contact Shelley Fox)

Business Office (bo)

BO - Accounts Payable
Employee Reimbursement Request: WVSAO ER1 |PDF (contact: Monica Cochran)
Receiving Report: WVSAO RR1 |PDF (contact: Monica Cochran)
Tax Exempt Certificate: SSTGB Form F0003 |PDF (contact: Monica Cochran)
Transfer of Expense Request |PDF (contact: Monica Cochran)
Vendor's Invoice |PDF (contact: Monica Cochran)
Wireless Device Stipend Agreement |Word Doc (contact: Monica Cochran)

BO - Inventory
Asset Disposal Reporting Form | PDF (contact: Caroly Fletcher)
Capital Equipment Transfers Reporting Form | PDF (contact: Caroly Fletcher)
Lost or Stolen Form | PDF (contact: Caroly Fletcher)
Return to Vendor Trade In Form | PDF (contact: Caroly Fletcher)

BO - Cash Handling
Cash Count Form | PDF (contact: Christa Kwiatkowski)

BO - Procurement
Account Codes – FY 2019 |PDF (contact: Monica Cochran)
Association Dues |PDF (contact: Monica Cochran)
Catering Request |PDF (contact: Monica Cochran)
Catering Request Procedures |PDF (contact: Monica Cochran)
Determination of Independent Contractor Worksheet |Word Doc (contact: Monica Cochran)
Independent Contractor Declaration |PDF (contact: Monica Cochran)
Purchase Change Request |PDF (contact: Monica Cochran)
Purchasing Affidavit |PDF (contact: Monica Cochran)
Purchasing Manual |PDF (contact: Monica Cochran)
Request for Taxpayer ID # and Certification (W-9 Form) |PDF Form (contact: Monica Cochran)
Request for Temporary Space: WV-15 |PDF (contact: Monica Cochran)
Requisition |PDF Form (contact: Monica Cochran)
Requisition for Space: WV-14 |PDF (contact: Monica Cochran)
Single-Sole Source Justification |Word Doc (contact: Monica Cochran)
Telephone Quotation Form |Excel (contact: Monica Cochran)
W-8BEN: Certificate of Foreign Status...for US Tax Withholding (Instructions) |PDF & W-8BEN Form |PDF Form (contact: Monica Cochran)
WV-1: WV Vendor Registration & Disclosure Statement |PDF (contact: M. Cochran) *over $1,000
WV-1A: WV Vendor Registration & Disclosure Statement |PDF Form (contact: Monica Cochran) *under $1,000
WV-48: Institution Vendor Agreement |PDF Form (contact: Monica Cochran)
WV-96: WV Vendor Agreement Addendum |PDF (contact: Monica Cochran)
WV-96A Agreement Addendum for Software|PDF (contact: Monica Cochran)

BO - Purchasing Cards
Hospitality Documentation |PDF (contact: Becky Miller)
Hospitality Guidelines |PDF (contact: Becky Miller)
How to Purchase Gift Cards with your PCard  |PDF (contact: Becky Miller)
Gift Card/Certificate Request Form  |PDF (contact: Becky Miller)
P-Card Application |PDF (contact: Becky Miller)
P-Card Cardholder Agreement |PDF (contact: Becky Miller)
P-Card Dispute Form |PDF (contact: Becky Miller)
P-Card Manual |PDF (contact: Becky Miller)
P-Card Missing Receipt Form |PDF (contact: Becky Miller
P-Card Purchase Justification |PDF (contact: Becky Miller)
P-Card Web-based Training Instructions |HTML (contact: Becky Miller)
P-Card Worksheet Fax Form |Excel (contact: Becky Miller)
Student Award Prize Form |PDF (contact: Becky Miller)

BO - Travel
Credit Card Hotel Authorization Form |Word Doc (contact: Dave Williams)
Exxon Card Affidavit |PDF (contact: Dave Williams)
Travel Settlement/Summary Form (contact: Dave Williams)
Travel Authorization  Instructions  | PDF
Travel Authorization  Request  | PDF
Travel Roster | PDF

Adjunct Faculty Information Form |PDF Form

Copy Center (cc)

Auditron Reporting Form |Excel (contact: Monica Cochran)
Copy Center Request Form |Web Form (contact: Georgeann Cain) *Note: Please be sure when you fill out this form that you fill it out COMPLETELY. Please specify whether the copies should be single- or double-sided and whether or not the document needs to be stapled.
Copy Center Request form (Write-In)|.PDF(contact: Georgeann Cain)

Facilities and Capital Projects (Physical Plant) (pp)

Custodial Evaluation Form
Key Request Form |Web Form (contact: Stephanie Slaubaugh) *Note: Restricted submission
Physical Plant Work Order |Web Form (contact: Stephanie Slaubaugh) *Note: Restricted submission
Supply Order Form |Excel (contact: Lenora Montgomery) *Physical Plant Purchasing/Shipping/Receiving
Supply Order Form Information |PDF (contact: Lenora Montgomery) *Physical Plant Purchasing/Shipping/Receiving
Special Supply Order Form |Excel (contact: Lenora Montgomery) *Physical Plant Purchasing/Shipping/Receiving

Faculty & Staff Awards and Foundation Grants (fsaw)

Visit the Center for Teaching Excellence

Fine Arts (fa)

Reservation Form for Wallman Hall |Word Doc (contact: Debby Rogers)

Human Resources Office (hr)

HR - Classification/Compensation
Adjunct Rates |PDF
Faculty CIP code description |Excel
Position Information Questionnaire |PDF

HR - Employment Forms
Payroll Forms |PDF (contact: Cinda Lu Ewing) *Includes: W-4 Forms, Resident/Non-Resident WV Withholding Forms, I-9 Forms, Direct Deposit Form, WV Higher Ed. Retirement Programs
Temporary Appointment Fringe Benefits Calculation forms: (Full Time) |Excel (Part Time) |Excel
Temporary Appointment For Special Program Online Instructions |PDF (contact: Maria Marshall)
Employee Fringe Benefits Calculation forms (Full Time) / Excel (Part Time) / Excel 
Time Sheet for Student Employees |PDF (contact: Cinda Ewing)
Selective Service System (Online and Fillable Registration Forms)
Time Sheet and Pay Schedule (contact: Steve Leach)
Important 403(b) Retirement Notice
Background Checks

HR - Departmental
Authorization for Unused Annual and Sick Leave Form
Name Address Change Form
Employee Occupational Injury/Illness Report | must be completed within 24 hours of injury
Student-Visitor Injury/Illness Report | must be completed within 24 hours of injury
Election of Option Form | must be completed if employee misses more than 3 days of work due to work-related injury

HR - Interview Process
Confidential Interview Evaluation Form |PDF
Pre-employment Inquiry Guide |PDF

HR - Leave of Absence
Catastrophic Leave Donation Request |PDF
Leave of Absence Options |PDF

HR - Miscellaneous Forms
Optional Employee Election To Reduce F.T.E. |PDF

HR – Separation from Employment
Separation from Employment – Part time staff (1039) and Casual (225 hr) Employees
Pierpont Voluntary Post Retirement Plan Form | PDF 

HR - Student Employees
Student Employment Information Sheet |PDF (contact: Kelly Kimble)
Student On-Line Pay Information |PDF  (contact: Kelly Kimble)

Information Technology (it)

IT - Administrative Systems
Project Request Form |Excel
Banner Access Request
Exit Form

IT - Application Services
Request to Migrate Section Template

IT - Networks, Security and Servers
Expense Transfer

IT - Project Management Office
Project Charter |Word Doc
Project Scope Definition |Word Doc
Project Baseline Schedule |Word Doc
Project Status Report |Word Doc

IT - Teaching & Learning Commons
Expense Transfer
IT Purchase Authorization Form Process
IT Purchase Authorization Form (PAF) |.pdf (contact: Robin Straiter)
Software Purchase
IT Work Order
Creating WebDAV Folders in Windows
Importing WebCT CE Content into Vista
Request to Migrate Section Template

Leadership Marion (lm)

Brochure |PDF (contact: Budd Sapp)
Application |PDF (contact: Budd Sapp)

Libraries (lib)

Library Instruction Request Form (On and Off-Campus) |HTML (contact: Charley Hively)


Permit to use alcoholic beverages on campus |PDF
Student Prize/Award Form|PDF

Public Relations and Marketing (pr)

Email Signature Block Word Template|Word docx(contact: Laura Williams)

Sponsored Grants Accounting (rs)

Grant Pre-Certification Form (GPCF) |Word Doc (contact: Sandy Shriver)
Final Proposal Certification Form (PCF) |Word Doc (contact: Sandy Shriver)
Grant Budget Creation Request |Excel Form (contact: Sandy Shriver)
Transfer of Funds Request |Excel Form (contact: Sandy Shriver)
Institutional Review Board (IRB) “Human subjects” Application |Word Doc (contact: Sandy Shriver)
Informed Consent Form |Word Doc (contact: Sandy Shriver)


Return to Content List

Admissions (adm)

Campus Visit Information (Schedule Individual or Group Tours) |HTML 
Join Our Mailing List |HTML
Online Undergraduate Application for Admission |HTML
Undergraduate Application for Admission & Residence Hall Lease |PDF
Academic Forgiveness Request Form|PDF
Residency Application|PDF
Application Signature Page|PDF


Financial Aid (fia)

Epay: Online Payment System |HTML

2018-19 FAFSA Verification Worksheet Dependent or Independent |PDF
Free Application for Federal Student Aid (FAFSA) |HTML
PLUS Loan Application |PDF
Standards of Satisfactory Academic Progress |PDF
SAP Appeal Form for Pierpont students |PDF

Application for PROMISE Scholarship  | HTML 
WV Invests Grant |HTML
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Multicultural Affairs:
Hunt-Arnold Scholarship Application |Drupal Form (contact: Tara Brooks) *Note: Not currently accepting applications - all awards have currently been disbursed.
Registrar's Office (ro)

Change of Major (contact: Enrollment Services)
Change of Name and/or Address |PDF (contact: Enrollment Services)
Enrollment Services Override Form|PDF (contact: Caitlin Rexrode)
Permission to Take Extra Hours | PDF (contact: Provost Office)
Prerequisite and Co-requisite Change Form | PDF Form (contact: Provost Office)
Transcript Request Form |PDF Form (contact: Enrollment Services)
Practice Schedule Form |PDF Form (contact: Caitlin Rexrode)
Student Registration Form |PDF Form (contact: Caitlin Rexrode)
Residency Application Form|PDF (contact: Caitlin Rexrode)
Registrar Appeal Form|PDF (contact:  Caitlin Rexrode)
Level Restriction/Duplicate Course Override |PDF (contact:  Caitlin Rexrode)
FERPA Form|PDF (contact:  Enrollment Services )
Transient Approval Form|PDF (contact:   Caitlin Rexrode)

Pierpont Community & Technical College (pc)

Pierpont Curriculum Proposal Form |Word Doc
Culinary Arts Application | PDF
Homeland Security Application | PDF
Pastry & Baking Arts Application | PDF

School of Health Careers
School of Health Careers General Application *Note: Students must complete a separate application for each program of study within the School of Health Careers. This is in addition to the PC&TC application.
Health Information Technology Application (HIT) |
Google Form (contact: Michael Wade)
Medical Laboratory Technology Application (MLT) |Google Form (contact: Michael Wade)
Physical Therapist Assistant Application (PTA) |Google Form (contact: Michael Wade)
Radiologic Technology Application (Rad Tech) |Google Form (contact: Michael Wade)
Respiratory Care Application (Resp Care) |Google Form (contact: Michael Wade)
Veterinary Technology Application (Vet Tech) |Google Form (contact: Michael Wade)

Workforce Development/Off-Campus Programs (cwe)

Center for Workforce Education-Registration
Apprentice Underground Miner "Red Hat" Online Registration |HTML (contact: Kimberly Cale)
Certified Procedural Coding Program |PDF (contact: Paul Schreffler)
Certified Protection Officer (CPO) Course |PDF (contact: Paul Schreffler)
Grant Writing Course |PDF (contact: Paul Schreffler)
NHLA Lumber Grading Program |PDF (contact: Paul Schreffler)
Oil & Gas Drilling - Floorhand Training Program |PDF (contact: Paul Schreffler)
Online Medical Transcription Training Program |PDF (contact: Paul Schreffler)

Center for Workforce Education-Financial Aid
WV Higher Education Adult Part-Time Student (HEAPS) Grant Program:
HEAPS Workforce Development Financial Aid Application |PDF (contact: Paul Schreffler)
Workforce Development Financial Aid Application FAQs |PDF (contact: Paul Schreffler)

Student Affairs - Campus Life (sl)

Residence Life (Housing)
All housing forms and applications can be found here

Student Affairs - Student Services (ss)

Crisis Counseling/Student Affairs Counselor
Notice of Absence

Disability Services

Americans with Disabilities Act | (contact:, 304-534-7878)
Rehabilitation Act  Section 504  |  Section 508  | (contact:, 304-534-7878)
Faculty Mentor LibGuide Website |(contact: 304-534-7878
Disability Accommodation Complaint Procedures for Students  | Online Form  (contact:, 304-534-7878)
Students Can Make an Appointment with a Disability Counselor   | Online Form  (contact:, 304-534-7878)
Link for All Faculty Online Forms Online Forms  (contact:, 304-534-7878)
Request Form for Interpreting Services |  Online Form (contact:, 304-534-7878)

Electronic Format Text Book Request Form for Students  | Online Form  (contact:, 304-534-7878)



Student Affairs - Student Activities (sa)

Feaster Center Trainer
Parent Letter / Instructions for Forms Completion
Acknowledgement of Risk
Physical Form
Insurance Protocol
Athletic Competition Release
Medical Information Release
Medical History

Intramural Sports

Intramural Sport Agreement Form |PDF (contact: Tina Mascaro)
Intramural Sports Roster |PDF (contact: Tina Mascaro)
Sport Commitment Sheet |PDF (custodian: Tina Mascaro)


Return to Content List

Pierpont Foundation Giving Opportunities (pf)

Irrevocable Stock/Bond Power |PDF
Make a Gift Via Check Using Regular Mail |HTML Form *Note: must be printed and mailed. <-----
Make a Gift Via Credit Card Using Regular Mail |HTML Form *Note: must be printed and mailed. <-----
Make a Pledge |HTML Form  <-----
Faculty and Staff Gift FormPDF

Public Safety (ps)

Anonymous Complaint
Parking Decal & Token Request |PDF
Parking Decal & Token Request |Word Doc
Accident Form |Word Doc