This page is designed for new hires of Hazard Community & Technical College.  Below are links to the necessary paperwork to place you on the payroll for the College.  The forms are fill-in forms which will allow you to enter your personal information and print out the page for signature.  You will not be able to save your information. 

Please complete and return the forms to: 

                             Human Resources Department

                             One Community College Drive

                             Hazard, KY  41701

 

Paper Applications:

Temp/Student Employment Application

Faculty Employment Application

Staff Employment Application

 

Hazard Community & Technical College New Hire Information Form  - This form is designed to provide basic information about you that the Human Resources Department will need for your personnel file. 

• Enter your name, mailing address and personal information (birthdate, social security number, telephone number and hire date.)
• Select your employment status from the selections provided.
• Enter the name of your supervisor and the campus location where you will be working.
• Answer the KTRS retirement question.
• Print out the form, sign and date it.

Background Check Release Form- These forms explain your rights under the Fair Credit Reporting laws and give HCTC authorization to perform the required background check on all new hires.

• Starting with Page 3, print your full name at the top of the form.
• Complete the middle section on form with your signature, social security number, birthdate, and driver's license information.
• Starting with your current address, list your address(es) for the past 7 years.

Background Check Acknowledgement Form - This form explains that HB 3 requires the background check and informs the new employee of the stipulations regarding the background check.

 

W-4 Federal Tax Withholding Form  - The information on this form is required to establish your tax status for federal taxes. 

• Enter your name, social security number and address information

• Select a tax status (Single, Married or Married but withhold at higher Single rate)
• On Line 5, enter the number of allowances (exemptions) you wish to claim for tax purposes.  (A rule of thumb is the more allowances claimed, the less amount of federal taxes paid. )

• If you meet the conditions explained in Line 7, you may write the word "Exempt" on that line and be exempted from paying federal taxes.

• Print out the form and sign and date it.

 

K-4 Kentucky State Tax Withholding Form  - The information on this form is required to establish your tax status for state taxes.

• Complete the name, address and social security number information at the top of form.

• Select the appropriate status on Line 1 or Line 2.

• Enter any additional exemptions for dependents on Line 4.

• Enter the total number of exemptions on Line 7.

• Print out the form and sign it.

Local Tax Form - This form is used by the payroll office to ensure that employees are paying the appropriate local occupational taxes

Direct Deposit Form - KCTCS has mandated that all employees enroll in direct deposit.  This form is required to provide your banking information for that purpose.  You may have your funds deposited into a checking account or savings account.  If you are using a checking account, you will be rquired to provide a VOIDED check as supporting documentation.  If you are using a savings account, you will need a letter from the bank containing the routing number and savings account information. 

NOTE:  If you are federal workstudy student and do not have a checking or savings account, contact the Human Resources Office at 487-3112.

• Enter you name at the top of form.
• Select the type of action being taken.  For new hires, this will be "New Enrollment".
• Enter your bank's name and address.
• Enter your routing number and account number
• Select "checking" or "savings" as the t ype of account
• If you are using a single account, enter "100%" in the percent box.
• If you are using multiple accounts, indicate the dollar amount to be deposited into this account and drop down to enter the next account's information.
• Print out the form, sign and date it.
• Attached the VOIDED check or letter from bank as supporting documentation

 

Drug-Free Policy Notification Form  - This form provides you with information about the drug policies of KCTCS.

• Read the information provided on the form.
• Enter your full name and social security number.
• Print out the form, sign and date it.

 

Guide to Possible Biohazards In the Work Place - This form explains the steps that should be taken if an employee suspects that he/she is exposed to possible biohazards in the work place. 

• Read the procedures.
• Enter your name and social security number.
• Print out the form, sign and date it.

Human Resources will secure the signature of the appropriate supervisor.

 

KCTCS Computer Account Usage Agreement  - This form explains the responsibilities of computer account users. 

• Read the procedures.

• Enter your full name.

• Print out the form and sign it.

All employees are assigned an email account as part of the employment process. For logon and password information contact the following individuals:

         Hazard Campus                             Donna Roark   487-3128

         Technical Campus                         Terry Conley   487-3355

         Lees College Campus                   James King    487-3564

         Knott County & Leslie County        Becky Neace  487-3127

 

Nepotism Form - This form is to be completed in accordance with KCTCS Administrative Policy 3.3.2 ( Nepotism ).

Eligibility for Voluntary Retirement Participation (KTRS) Form - This form explains the voluntary retirement participation guidelines and in identifies individuals who are retirees from the Kentucky Teachers Retirement System.  NOTE:  It is not required for student employees.

• Answer question #1.  If the answer if no, skip to #3.
• If the answer to question #1 is yes, complete the information in question #2.
• Print your name and ssocial security number on the form.
• Print out the form, sign and date it.

 

On-Line Prevention of Sexual Harrassment Training - All employees of KCTCS are required to have training on the prevention of sexual harrasment in the workplace.  This link will take you to an on-line training.  This training will take approximatley 30-45 minutes to complete. 

At the end of the training, you will take a short exam.  You must score at least 73% to pass the training. 

Upon completion of the test, a pop-up screen with a "Certificate of Completion" will appear. You are asked to type in your first and last name, to select the college district from a drop down menu (Hazard) and to select the school name ( Hazard Community & Technical College). Complete this information and hit 'submit". A Certificate of Completion" will appear with your personal information.   NOTE:  This step will not occur if you have a pop-up blocker on your computer.

Print this certificate and present it to the Human Resources Office for your personnel file.  Completion of the sexual harrasment training is a condition of employment. 

Harrassment Acknowledgement Form and Harrassment Free Workplace Brochure - This form acknowledges receipt of the Harrassment Free Workplace Brochure.

FERPA Training - All employees at HCTC who will have access to student information are required to complete a short training session on FERPA regulations.  at the end of the training, you will take a short exam.  You must score 73% to pass the exam.  Print out a copy of the exam showing your passing score and return it to Human Resources.