Forms
Employment forms:
Health Insurance
Following links mark with this symbol † will take you out of the SUNY Orange Web site. The college cannot be responsible for the content on these pages, although the links on this page have been reviewed and are recommended by the members of the Human Resource Department.
- Empire Claim Form†
- Mental Health & Substance Abuse Claim form†
- Request for Empire Plan replacement card
Dental/Vision Insurance
Retirement
Section 125
Tuition Remission
- Remission Form (credit classes for dependents & spouse)
- Waiver Form (noncredit classes for dependents/spouse; credit classes for self)
- Dependency Form
Other:
If you have any problems accessing these forms, please contact Human Resources.
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Human Resources Information:
Phone: (845) 341-4660Fax: (845) 341-4670
Located in Orange Hall,
115 South Street Middletown, NY 10940
occchr@sunyorange.edu