K-State Research and Extension - County | District Forms


Benefits/ Payroll Information/ Leave Forms

Ext. Form File Name Title & Description User Instructions
logos>Printer Logo EXOP3-2.pdf Overtime Compensation Agreement for
 Non-Exempt Employees
Instructions
logos>pdf FMLA 1-1 to 1-8 Family and Medical Leave Act Overview
(FMLA) & forms
Instructions
logos>pdf KSU1-11.pdf Payment of Health Care Premiums
for State of Kansas Employee Health
Care Program for Non-State Groups
Instructions
logos>pdf KSU1-11b.pdf Notice of Intent to Participate in the State of Kansas Health Care Program for
Non-State Groups
Instructions
logos>pdf Bank Draft Approval for State of Kansas
Employee Health Care Program for
Non-State Group
Instructions
logos>xls KSU8-25.xls Record of Hours Worked and Leave for
Office Professionals
(Excel)
Instructions
logos>Printer Logo KSU8-25.pdf Record of Hours Worked and Leave for
Office Professionals
(Print Only)
Instructions
logos>pdf KSU8-32.pdf Consulting Request for Use by Extension Agents Instructions
KSU8-42.xls Local Unit Employee Leave Monthly Summary Instructions
PR-5 FY 2015 Unclassified Annual and Sick Leave Record
for FY 2015
Instructions
PR-5 FY 2015 Excel Unclassified Annual and Sick Leave Record
for FY 2015 (Excel)
Instructions
For Classified Annual & Sick Leave Forms visit Division of Human Resources -
Forms Page
(Leave Record)
 

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Budgets and Financial Forms

Ext. Form File
Name
Title & Description User
Instructions
logos>pdf GAAP1-1 & 1-2.pdf
 
Generally Accepted Accounting Principles
(GAAP) Waiver Resolution for Extension
Councils and District Governing Bodies
Instructions
logos>pdf KSU1-13.pdf Responsibilities for Extension Local Unit
Administration of Extramural Funds Form
 
logos>pdf KSU1-14.pdf Electronic Funds Transfer Authorization Instructions
logos>pdf KSU1-18.pdf Direct Deposit of Salary Authorization Instructions
logos>Printer Logo KSU4-1 to 4-4 - Financial Review Committee Responsibilities
- Financial Review Checklist
- Annual Financial Report
- 4-H Club Treasurer Job Description
Instructions
logos>pdf KSU8-1.pdf Budget for County Extension Council Instructions
logos>pdf KSU8-2.pdf Certificate of Filing County Extension
Budget
Instructions
logos>Printer Logo KSU8-3.pdf Certificate of Appropriation - Print Only Instructions
logos>pdf KSU8-10.pdf County Equipment Inventory Instructions
logos>xls KSU8-10.xls County Equipment Inventory
(Excel)
Instructions
logos>wb3 KSU8-10.wb3 County Equipment Inventory
(Quattro Pro)
Instructions
logos>pdf KSU8-17.pdf Travel Payment Voucher Instructions
logos>xls KSU8-19.xls Financial Check Sheet with Budget
Development and Management
Worksheets
(Excel)
Instructions
logos>pdf KSU8-34.pdf Transfer of Property and Funds
(From County Extension Councils to
Extension Districts)
Instructions
logos>pdf KSU8-35.pdf Invoice Instructions
logos>Printer Logo KSU8-36.pdf Vehicle Daily Log Instructions
logos>xls KSU8-37.xls Salary Proposal Worksheet Instructions
logos>xls KSU8-39.xls Extension Council/District Staff
Salary and Benefits Record
Instructions
logos>xls KSU8-41.xls Program/Service Costs Calculation
Worksheets (On-Campus and Off-Campus)
Instructions
logos>pdf KSU9-10.pdf District Equipment Inventory Instructions
logos>xls KSU9-10.xls District Equipment Inventory
(Excel)
Instructions
logos>wb3 KSU9-10.wb3 District Equipment Inventory
(Quattro Pro)
Instructions
KSU9-19.xls District Financial Check Sheet with
Budget & Development & Management
Worksheets (Excel)
Instructions

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Civil Rights Forms

Ext. Form File Name Title & Description
User Instructions
logos>pdf CR-1 Annual Civil Rights Mini-Review  
logos>pdf CR-2

Civil Rights Program Compliance Review Guide 2010-2013


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Crisis Management Forms

Ext. Form File Name Title & Description
User Instructions
logos>pdf KSU8-33.pdf

Crisis Management Planning Instructions
logos>pdf KSU8-33a.pdf Crisis Management Planning -
Pocket Form
Instructions

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Employment Forms

Ext. Form File Name Title & Description User Instructions
logos> Conflict of
Interest
Declaration of Conflict of Interest and
Time Commitment Forms - KSU
Instructions
logos>pdf EXOP3-5 Approval to Employ an Extension Program Assistant Instructions
logos>pdf EXOP3-7 Applicant Information Profile
Office Professionals and Program Assistants
Instructions
logos>Printer Logo EXOP3-9 Screening of Office Professional and Program Assistant Applicants Prior to Interview
(Print Only)
Instructions
logos>pdf EXOP3-11 Employment Agreement
Office Professionals and Program Assistants
Instructions
logos>pdf EXOP3-13 Employee Performance Review
Office Professionals and Program Assistants
Instructions
logos>pdf EXOP3-15 Personnel Action Form
(For Area Office Use Only)
Instructions
logos>pdf EXOP3-16 Extension Agent Exit Interview Instructions
EXOP3-17 Employee Separation Checklist
for Local Unit
Instructions
EXOP3-18 Exit Interview
Office Professional and Program Assistant
Instructions
logos>pdf KSU1-2.pdf Extension Agent Employment Agreement Instructions
logos>pdf KSU1-16.pdf Area Specialist Performance Appraisal
Input Form
Instructions
logos>xls KSU1-17.xls Recruiting/Offer Form Instructions
logos>Printer Logo KSU8-29OP Office Professional - Application for
Employment - Print Only
Instructions
logos>Printer Logo KSU8-29PA Program Assistant - Application for
Employment - Print Only
Instructions
logos>pdf KSU8-29OP.pdf Office Professional - Application for Employment
(This form can be filled in and printed)
Instructions
logos>pdf KSU8-29PA.pdf Program Assistant - Application for Employment
(This form can be filled in and printed)
Instructions
 logos> Link to Login Annual Extension Agent Performance Review
Electronic Version
 
logos>pdf KSU8-30a.pdf Annual Extension Agent Performance
Review
Instructions
logos>pdf KSU8-30b.pdf Annual Extension Agent Performance
Review:  Summary
Instructions
logos>pdf KSU8-30c.pdf Annual Extension Agent Performance
Review:  External Feedback
Instructions

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Extension Council and Governing Body Forms

Ext. Form File Name Title & Description User Instructions
logos>Printer Logo KSU8-38.pdf

Template for Extension Board Meeting Minutes

Instructions
logos>Printer Logo KSU8-40.pdf Excellence in Board Leadership
Board Assessment
 
Making a Difference Making a Difference Template - Local Units Instructions
Making a Difference Template - SAMPLE Making a Difference Template - Local Units
SAMPLE
 
logos>pdf PM1
 
Handbook for County Extension Councils
and District Governing Bodies
Instructions
  Council Forms    
logos>pdf KSU8-4a.pdf

 
Extension Council Executive Board
Members and County Extension Council
Members elected by Commissioner Districts
Instructions
logos>pdf KSU8-4b.pdf
 
Extension Council Executive Board
and County Extension Council
Members elected At Large
Instructions
logos>xls KSU8-4a&b.xls Extension Council Executive Board Members and County Extension Council Members
(Excel)
Instructions
logos>pdf KSU8-10.pdf County Equipment Inventory Instructions
logos>xls KSU8-10.xls County Equipment Inventory
(Excel)
Instructions
logos>wb3 KSU8-10.wb3 County Equipment Inventory
(Quattro Pro)
Instructions
logos>pdf KSU8-15.pdf Extension Council Member Record Instructions
KSU8-15.xls Extension Council Member Record - Excel Instructions
logos>pdf KSU8-20.pdf Oath to support U.S. and Kansas
Constitution, County Version
Instructions
logos>pdf KSU8-23.pdf Public Notice of Annual Meeting of County
Extension Council
Instructions
logos>pdf KSU8-24a.pdf Public Notice of Extension Council Election
at Large
Instructions
logos>pdf KSU8-24.pdf Public Notice of Extension Council Elections
at Three Locations
Instructions
  District Forms    
logos>pdf KSU8-34.pdf Transfer of Property and Funds
(From County Extension Councils to
Extension Districts)
Instructions
logos>xls KSU 9-4.xls Governing Board of the Extension District
(Excel)
Instructions
logos>pdf KSU9-4.pdf
 
Governing Board of the Extension District Instructions
logos>pdf KSU9-5.pdf District Operational Agreement Instructions
logos>pdf KSU9-6.pdf District Office Space Agreement Instructions
logos>pdf KSU9-10.pdf District Equipment Inventory Instructions
logos>xls KSU9-10.xls District Equipment Inventory
(Excel)
Instructions
logos>wb3 KSU9-10.wb3 District Equipment Inventory
(Quattro Pro)
Instructions
logos>pdf KSU9-15.pdf Governing Body Member Record Instructions
KSU9-15.xls Governing Body Member Record - Excel Instructions
logos>pdf KSU9-20.pdf Oath to support U.S. and Kansas
Constitution, District Version
Instructions

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Master Farmer - Master Farm Homemaker Forms

Ext. Form File Name Title & Description User Instructions
logos>pdf KSU1-10.pdf
 
Kansas Master Farmer-Master Homemaker
Workbook 
Instructions

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Sabbatical and Study Leave Application Forms

Ext. Form File Name Title & Description User Instructions
logos> Application
 
Application for Sabbatical Leave from
Kansas State University
 
logos> Guidelines Guidelines for Sabbatical Leave from
Kansas State University
 
logos>pdf KSU1-9c.pdf
 
Application for Study Leave other
than Sabbatical Leave
Instructions

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