Forms Online

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.

Student and Public Accident Report

Action Plan Funding Request Form

Download the 2025-2026 Action Plan Funding Request Form and submit to the department chair by October 18, 2024.

Action Plan Funding Request Form

Business Card Request Form

To request business cards, please forward signed form to Leslie King in Administration.

Business Card Request Form (docx)

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.

SCCCD Certificated Monthly Report

Cheating & Plagiarism Infraction Form

Please follow these procedures when addressing dishonesty, cheating or plagiarism: (1) Complete this form (2) Meet with student to discuss the incident (3) Submit the form & supporting evidence to your Division Dean (4) the Division Dean will forward all documents to the Dean of Student Services.

Cheating & Plagiarism Infraction Form (PDF)

Disruptive Student Behavior Report

Instructions: 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 and submit it directly to the Dean of Students in the Office of the Deans suite (AC2 235).

Disruptive Student Behavior Report (PDF)

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.

Download the form

Exhibitor Guidelines Release and Indemnification Agreement

Exhibitor Guidelines Release and Indemnification Agreement

Download the form

Facilities Request Form

Application / Permit for use of college facilities on Clovis Community College Campus and Herndon Campus.

Facilities Request Form

Faculty Evaluation Form

This is an evaluation form for faculty and staff. Please make sure all information is completed and signed by Observer.

Faculty Evaluation Form

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.

Classified Staff Enrollment Fee Waiver Request Form

Mileage Report Form

Please submit for the full calendar month. If the reimbursement amount is nominal you may submit on a quarterly basis.

MIleage Reimbursement Form

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.

Preferred Name Change Form

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.

Request for Incomplete Grade Form

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)

Online Training Course Registration Form

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 Field Trip Form

Supplies Requisition Form

Also known as the Green Sheet Requisition Form, used for requesting supplies and equipment. Approval signatures required.

Supplies & Equipment Requisition Form (xlsx)

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 Request Form Instructions

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 earlyreservations are made.

Travel or Conference Authorization Request Form

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.

Travel or Conference Reimbursement Form