Accident Report Form
The Student and Public Accident Report Form is initiated by the main employee witness or first employee aware of the accident/injury.
Action Plan Funding Request Form
Download the 2025-2026 Action Plan Funding Request Form and submit to the department chair by October 18, 2024.
Business Card Request Form
To request business cards, please forward signed form to Leslie King in Administration.
Care and Concern - BIT Referral
The purpose of this form is to report any non-emergent student/faculty/staff concerns including mental health concerns, physical health concerns, basic needs concerns, persons experiencing a traumatic event, odd behavior, etc. Once the form is submitted, it will automatically be sent to members of the BIT team who will provide support and resources to the person of concern. If additional information is needed, you will be contacted.
Certificated Monthly Report
This is a time sheet for faculty and staff on special assignments or projects. Please make sure all information is completed and signed by your supervisor and your Dean / Vice President.
Cheating and Plagiarism Infraction Form
Please follow these procedures when addressing dishonesty, cheating or plagiarism: (1) Meet with student to discuss the incident and any penalties (2) Submit the form and all supporting evidence using this form. Once submitted, the electronic form will be automatically sent to the Dean of Student Services and your area Dean. If additional information is needed, you will be contacted.
Disruptive Student Behavior Report
The purpose of this form is to help faculty/staff resolve situations created by disruptive students and/or to report other behaviors that are of concern. Please complete the form promptly within 24 hours after incident. Once submitted, the form will automatically be sent to the Dean of Student Services. If additional information or follow-up is needed, you will be contacted.
Employee Voluntary Payroll Deductions
The SCCCD Employee Voluntary Payroll Deduction form for those wanting to make a tax-deductible monthly contribution to the State Center Community College Foundation.
Exhibitor Guidelines Release and Indemnification Agreement
Exhibitor Guidelines Release and Indemnification Agreement
Facilities Request Form
Application / Permit for use of college facilities on Clovis Community College Campus and Herndon Campus.
Faculty Evaluation Form
This is an evaluation form for faculty and staff. Please make sure all information is completed and signed by Observer.
Fee Waiver Request Form
This form should be used for two purposes: 1) To request a waiver of enrollment fees, and/or 2) to request a modified work schedule to attend a course during your normally scheduled work hours. Enrolling prior to the first day of class will nullify your ability to request a fee waiver. The completed form should be forwarded to the business services office for processing.
Mileage Report Form
Please submit for the full calendar month. If the reimbursement amount is nominal you may submit on a quarterly basis.
Preferred Name Change Form
This form is for students who wish to use their chosen name instead of their legal name for interactions within the Canvas Learning Management System at State Center Community College District. Please be advised that your permanent record will reflect your legal name unless you legally change your name through the courts and notify Admissions and Records.
Request for Incomplete Grade
For situations where a student is unable to complete all of the coursework due to a serious and verifiable reason, download and fill out the form to request an incomplete grade.
Signing Up for DE Certification
Spring 2022 Online Training Certification (TBA) | Online Course Redesign (self-paced) | Applying the Peralta Equity Rubric (self-paced) | Accessibility in Canvas (self-paced) | Microsoft Word Accessibility (self-paced) | Microsoft PowerPoint Accessibility (self-paced)
Student Field Trip and Activities Form
If you are interested in taking students on a field trip next year, please complete the form along with your dean's signature and email it to Lorrie Hopper, and copy Cathy Ostos, by April 26.
Student Representation Fee Waiver Form
In the Associated Student Government Election of Spring of 2001, the student body of Fresno City College approved a $1.00 Student Representation Fee. This fee will be used for student advocacy at the local, state and national levels.
Supplies Requisition Form
Also known as the Green Sheet Requisition Form, used for requesting supplies and equipment. Approval signatures required.
Title IX Reporting Form
The purpose of this form is to report any Title IX Violations. Under Title IX, discrimination on the basis of sex can include sexual harassment, rape, domestic violence, dating violence, sexual assault, and stalking that limits a student’s ability to participate in educational programs and activities or an employee’s ability to work in an educational setting. Many Faculty and Staff are mandated reporters and must report any concerns promptly. Once submitted, the form will automatically be sent to the Title IX Coordinator for review.
Travel or Conference Request Form Instructions
The online version of the District’s Travel or Conference Request form has been separated into two forms: the Travel or Conference Authorization Request and the Reimbursement form.
Travel or Conference Authorization Request Form
Prior to completing this authorization form, the employee should receive verbal travel approval from their supervisor. The best rates are received when early reservations are made.
Travel or Conference Reimbursement Form
Attach Travel or Conference Authorization Request and receipts with this reimbursement form; failure to attach these items may delay payment.
