Benefits

Forms and Resources

Below you’ll find forms related to Health Benefits, FlexCash, Parking, Voluntary Benefits, the Fee Waiver Program, Family and Medical Leave, Catastrophic Leave, Nonindustrial Disability, and Pregnancy Disability. Select a heading—Benefits, Fee Waiver, or Leaves—to view all available forms for that section.

If you’re unable to locate a specific form, please contact Human Resources at (559) 278-2032 for assistance.

All Enrollment Benefit Forms will need to be submitted using AdobeSign.

Health & Dental Enrollment

Vision Plan Premier Enrollment

Other Resources

Catastrophic Leave Donation Program (CLDP) Donation Form
Request for Participation Form - Please contact the Leave Coordinator, Jennifer Olsen, for Participation Form
Summary

Admission Data Form

Fee Waiver Application:

Fee Waiver applications for Spring 2026 will be available beginning November 17, 2025. If you need to apply for the waiver before that date please contact your Fee Waiver Coordinator.
Career Development Plan (CDP) Form last name A-L
Career Development Plan (CDP) Form last name M-Z

Fee Waiver Coordinators
Last Name A-L Debra Penner HR Professional II dpenner@csufresno.edu 559.278.4657	Last Name M-Z Esmeralda Cruz HR Professional I escruz@csufresno.edu 559.278.5014

If you need more information on medical and non-medical leaves of absence, or need to start the process, complete the Leave Inquity form or contact the Leaves Coordinator.

Jennifer Olsen
Confidential Leaves and Accommodations Coordinator
jennolsen@csufresno.edu
559.278.5345

Pre-Tax Parking Deduction Plan Cancellation Form

Forms and Resources

Benefits - Health, Dental and Vision Enrollment Worksheets

Flexible Spending (HCRA/DCRA)

Catastrophic Leave Donation Program

Fee Waiver

Fee Waiver Application:

Last Name A-L

Last Name M-Z

Leaves

Pre-Tax Parking