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Benefits Forms

Cape Fear Community College Forms & Links 2017-2018

2017 Benefits Forms
Ameritas Dental/Vision Change Form
Ameritas Dental Reimbursement Form
Ameritas Vision Reimbursement Form
Flexible Spending Reimbursement Form
Humana Disability Claim Form
NC 401(k) Enrollment Form
NC 401(k) Change Form
ACA Health Insurance Coverage Options


Tax and Payroll Forms

For additional and up-to-date payroll information, please visit the Payroll Department’s intranet page found in MyCFCC

Form W4 (federal withholding)
Form NC-4 (state withholding)
Form NC-4EZ (state withholding)
Direct Deposit Form (full time employees)
Direct Deposit Form (part time employees)

Evaluation Forms (blank)

2017 CFCC Staff Evaluation Form
2017 CFCC Staff Supervisor Evaluation Form
2017 CFCC Dep Chair Evaluation Form
2017 CFCC Faculty Evaluation Form
2017 CFCC Prog Dir-Hybrid Faculty Evaluation Form

CFCC Self-Assessment Template

OtherĀ Forms (blank)
Employee Incident Report Form
Official Personnel File Access Request Form
Address Change Form (link to intranet form)

Educational Leave Request Form
Request for Secondary Employment Form
Request for Outside Employment Form
Shared Leave Request Form
Shared Leave Request Form – other agency

Additional forms (including PeopleAdmin training manuals, reference check forms, and others) may be found on the Human Resources link on the intranet.

Wilmington Campus
411 North Front Street
Wilmington, NC 28401
(910) 362-7000

North Campus
4500 Blue Clay Road
Castle Hayne, NC 28429
(910) 362-7700

Burgaw Center
100 East Industrial Drive
Burgaw, NC 28425
(910) 362-7900

Hours of Operation
Monday-Friday: 8:00am to 5:00pm

Accessibility Services

Cape Fear Community College does not discriminate on the basis of race, color, national origin, sex, disability, religion, political affiliation or age.