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MCSC Forms

This page lists and describes Civil Service forms available for printing or downloading. To find a form, select the form from in one of the drop-down lists below grouped by type. Use the Helpful tips and instructions for downloading in Microsoft Office 2003 format (with macros to add sections/pages to the form), or PDF format (with fill-in fields to enter text), or the Civil Service Forms FAQ page .

To enable all the form features, select the "Enable Macros" button when you open the templates (also see FAQs or Disabled Macros Error).

Documents edited in PDF format cannot be saved or e-mailed electronically unless you have a software license with Adobe Acrobat. If you do not have a license, you must either mail the documents to the address provided on the documents, or fax them to the fax number indicated on the documents.

Forms for State Employees and Applicants

Applications for Examinations

Forms for Managers and Personnel Staff

Your questions and comments are welcome.
Send them to the Civil Service Internet Team.
Revised: November, 2012

Exam Application Name and Number	Microsoft Office 2003 Format	PDF Format
Corrections Nonprofessional Supervisors Examination Application 4081 *Revised 7/2012*	App4081.dot	App4081.pdf
Entry-Level Law Enforcement Examination Application 2002 *Revised 9/2012*	App2002.dot	App2002.pdf
Entry-Level Security Examination Application 4012 *Revised 7/2012*	App4012.dot	App4012.pdf
State Police Lieutenants Examination Application 2022 (state employees only) *Revised 3/2012*	App2022.dot	App2022.pdf
State Police Sergeants Examination Application 2012 (state employees only) *Revised 7/2012*	App2012.dot	App2012.pdf


Form Name and Number	Microsoft Office 2003 Format	PDF Format
Adding Names to Applicant Pools for Examinations Already Taken and Passed CS-1706 *Revised 9/2010*	CS1706.dot	CS1706.pdf
App to Continue Insurances CS-1820 This Form is for Employee Benefits, Human Resource Offices, and Retirement Use Only Revised 8/2012	CS1820.dot	CS1820.pdf
Application for Leave to Appeal to the Employment Relations Board CS-1743 *Revised 1/2011*	CS1743.dot	CS1743.pdf
Application for Persons with Disabilities and Request for Reasonable Accommodation in the Written Examination Process CS-944 *Revised 5/2011*	CS944.dot	CS944.pdf
Application for the Twelve-Month Trial Appointment Program for Handicappers CS-630 *Revised 7/2009*	CS630.dot	CS630.pdf
Beneficiary Designation Change CS-1781 Revised 5/2010	CS1781.dot	CS1781.pdf
Benefit Enrollment Application CS-1777 Revised 5/2011	CS1777.dot	CS1777.pdf
Brief in Response to Application for Leave to Appeal to the Employment Relations Board CS-1754 *Revised 2/2011*	CS1754.dot	CS1754.pdf
Civil Service Position Description CS-214 Instructions for CS-214.doc Instructions for CS-214.pdf Revised 8/2007	CS214.dot	CS214.pdf
Claim of Appeal as of Right to the Employment Relations Board CS-1756 Revised 2/2011	CS1756.dot	CS1756.pdf
Dependent Care Flexible Spending Account Mid-Year Enrollment CS-1774 Revised 4/2010	CS1774.dot	CS1774.pdf
Disability Accommodation Request by Employee CS-1668 *Revised 6/2009*	CS1668.dot	CS1668.pdf
Disclosure of Interest CS-1783 Revised 4/2007	CS1783.dot	CS1783.pdf
Final Compensation Beneficiary Affidavit CS-140a *Revised 8/2007*	CS140a.dot	CS140a.pdf
Final Compensation Beneficiary Designation CS-140 Revised 8/2007	CS140.dot	CS140.pdf
Flexible Spending Accounts Life Event/Election Change CS-1784 Revised 10/2010	CS1784.dot	CS1784.pdf
FMLA_Leave of Absence Request_Response CS-1810 Revised 5/2012	CS1810.dot	CS1810.pdf
Grievance Form CS-100 *Revised 4/2011*	CS100.dot	CS100.pdf
Group Appeal Contact Information (CS-1793) *Revised 1/2011*	CS1793.dot	CS1793.pdf
Health Care Flexible Spending Account Mid-Year Enrollment CS-1773 Revised 4/2010	CS1773.dot	CS1773.pdf
Health Care Flexible Spending Account Continuation of Coverage CS-1814 *Revised 3/2012*	CS1814.dot	CS1814.pdf
HIPAA Disclosure Authorization CS-1786 Revised 5/2004	CS1786.dot	CS1786.pdf
HIPAA Privacy Complaint Form CS-1782 Revised 4/2011	CS1782.dot	CS1782.pdf
Life Insurance and Accidental Duty Death Enrollment and Beneficiary Form CS-1717 This Form is for Judicial State Employees Use Only *Revised 11/2007*	CS1717.dot	CS1717.pdf
Non-FMLA Medical Certification by Physician CS-1835 *New 2/2012*	CS1835.dot	CS1835.pdf
Notification by Employee/Retiree of Qualifying Event CS-1766 Revised 8/2007	CS1766.dot	CS1766.pdf
OEAI Application and Affidavit CS-1833 Revised 7/2012	CS1833.dot	CS1833.pdf
Parking Account Enrollment CS-1776 Revised 11/2011	CS1776.dot	CS1776.pdf
Parking Account Reimbursement CS-1779 Revised 6/2010	CS1779.dot	CS1779.pdf
Petition for Election CS-1760 Revised 4/2011	CS1760.dot	CS1760.pdf
Proof of Service to Other Parties to the Employment Relations Board CS-1740 *Revised 4/2011*	CS1740.dot	CS1740.pdf
Request to Order Witnesses to Appear or Produce Documents CS-1747 *Revised 10/2012*	CS1747.dot	CS1747.pdf
Technical Appointment Complaint CS-212d *Revised 1/2008*	CS212d.dot	CS212d.pdf
Technical Appointment Complaint Proof of Service to Appointing Authority CS-1759 To be used for Technical Appointment Complaints Only Revised 8/2007	CS1759.dot	CS1759.pdf
Technical Classification Complaint CS-212a *Revised 1/2008*	CS212a.dot	CS212a.pdf
Technical Disbursement Complaints CS-212c *Revised 1/2008*	CS212c.dot	CS212c.pdf
Technical Qualification Complaint CS-212b *Revised 1/2008*	CS212b.dot	CS212b.pdf
Unclassified Position Description CS-133 *Revised 1/2008*	CS133.dot	CS133.pdf
Verification of Eligibility CS-1830 *Revised 3/2012*	CS1830.dot	CS1830.pdf
Vets Preference Registration Form CS-1791 *Revised 2/2011*	CS1791.dot	CS1791.pdf

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FORMS FOR MANAGERS & PERSONNEL STAFF
Click here to e-mail any of the following forms as an attachment
Note: Form must be saved to your computer prior to e-mailing as an attachment.

Form Name and Number	Microsoft Office 2003 Format	PDF Format
Agency Candidate Credential Review Certifications CS-1753 *Revised 7/2009*	CS1753.dot	CS1753.pdf
Agency Training Coordinators Security Agreement CS-1748 *Revised 8/2007*	CS1748.dot	CS1748.pdf
Appointing Authority's Comments on Technical Appointment Complaint CS-1812 *New 1/2009*	CS1812.dot	CS1812.pdf
Appointing Authority's Comments on Technical Classification Complaint CS-1627 *Revised 8/2007*	CS1627.dot	CS1627.pdf
Assistant Attorney General Performance Management and Competency Rating Form CS-1762 Attorney General Competency Model.doc Attorney General Compentency Model.pdf *Revised 8/2009*	CS1762.dot	CS1762.pdf
Civil Service Position Description CS-214 Instructions for CS-214.doc Instructions for CS-214.pdf *Revised 8/2007*	CS214.dot	CS214.pdf
Discriminatory Harassment Work Rule Revised 8/2007	Harrass.dot	Harrass.pdf
Employee Departure Report CS-301 *Revised 6/2011*	CS301.dot	CS301.pdf
Employee Personal Data CS-1785 This Form is for Human Resource Offices Use Only *Revised 7/2010*	CS1785.dot	CS1785.pdf
Employment History File Correction Request CS-1705 *Revised 7/2009*	CS1705.dot	CS1705.pdf
Evaluation of Disability Accommodation CS-1670 *Revised 8/2007*	CS1670.dot	CS1670.pdf
Family Medical Leave of Absence Form CS-1787 This Form is for Employee Benefits and Human Resource Offices Use Only *Revised 9/2011*	CS1787.dot	CS1787.pdf
Group Four and Senior Executive Service Performance Management and Competency Rating Form CS-1719 Competency and Rating Scales for Group 4 and Senior Executive Service.doc Competency and Rating Scales for Group 4 and Senior Executive Service.pdf *Revised 10/2010*	CS1719.dot	CS1719.pdf
Group One Employees Performance Management and Competency Evaluation Form CS-1750 Group One Behaviorally Anchored Rating Scales.doc Group One Behaviorally Anchored Rating Scales.pdf *Revised 10/2010*	CS1750.dot	CS1750.pdf
Group Three Managers Performance Management and Competency Rating Form CS-1761 Group Three Managers Competency Rating Scales.doc Group Three Managers Competency Ratings Scales.pdf *Revised 10/2010*	CS1761.dot	CS1761.pdf
Group Three Supervisors Performance Management and Competency Rating Form CS-1752 Group Three Supervisor Competencies Behaviorally Anchored Rating Scales.doc Group Three Supervisor Competencies Behaviorally Anchored Rating Scales.pdf *Revised 10/2010*	CS1752.dot	CS1752.pdf
Group Two Employees Performance Management and Competency Evaluation Form CS-1751 Group Two Behaviorally Anchored Rating Scales.doc Group Two Behaviorally Anchored Rating Scales. pdf *Revised 10/2010*	CS1751.dot	CS1751.pdf
Identification of Priority Programs CS-1796 *New 7/2007*	CS1796.dot	CS1796.pdf
Information Technology Position Evaluation Worksheet CS-1763 *Revised 7/2009*	CS1763.dot	CS1763.pdf
Information Technology Programmer/Analyst Trainee Program Appointment Agreement CS-1755 *Revised 7/2009*	CS1755.dot	CS1755.pdf
Interim Employee Rating CS-375 *Revised 7/2009*	CS375.dot	CS375.pdf
Oath of Office CS-314 *Revised 8/2007*	CS314.dot	CS314.pdf
Plan C Leave of Absence Form CS-1788 This Form is for Employee Benefits and Human Resource Offices Use Only *Revised 9/2011*	CS1788.dot	CS1788.pdf
Position Bench Strength Assessment CS-1803 *New 7/2007*	CS1803.dot	CS1803.pdf
Position Impact Risk Assessment CS-1798 *New 7/2007*	CS1798.dot	CS1798.pdf
Position Impact Risk Assessment Description CS-1799 *New 7/2007*	CS1799.dot	CS1799.pdf
Position Recoding Worksheet CS-1758 Instructions for CS-1758.doc Instructions for CS-1758.pdf *Revised 7/2009*	CS1758.dot	CS1758.pdf
Position Request CS-1795 Revised 9/2008	CS1795.dot	CS1795.pdf
Position Risk Assessment Attrition Factor CS-1800 *New 7/2007*	CS1800.dot	CS1800.pdf
Position Success Profile CS-1801 *New 7/2007*	CS1801.dot	CS1801.pdf
Position Success Profile-Group 2 CS-1802 *New 7/2007*	CS1802.dot	CS1802.pdf
Priority Programs and Human Capital Alignment CS-1797 *New 7/2007*	CS1797.dot	CS1797.pdf
Request for Credential Review CS-153 Credential Review Procedures.pdf Prescreen Procedures.pdf *Revised 7/2009*	CS153.dot	CS153.pdf
Request for Employment List Extension CS-1500 *Revised 7/2009*	CS1500.dot	CS1500.pdf
Request for Prior Employment History CS-1704 *Revised 1/2012*	CS1704.dot	CS1704.pdf
Response to Disability Accommodation Request CS-1669 *Revised 8/2007*	CS1669.dot	CS1669.pdf
Senior Executive Management Assistant Service (SEMAS) Limited-Term Employment Agreement CS-1738 *Revised 6/2009*	CS1738.dot	CS1738.pdf
Senior Executive Service Limited-Term Employment Agreement CS-1720 *Revised 8/2007*	CS1720.dot	CS1720.pdf
State Police Performance Management and Competency Rating Form CS-1792 Competency and Rating Scales for State Police Troopers and Sergeants.doc Competency and Rating Scales for State Police Troopers and Sergeants.pdf *Revised 8/2009*	CS1792.dot	CS1792.pdf
Survey on the Quality of the Agency Candidate Pool CS-1745b *Revised 7/2009*	CS1745b.dot	CS1745b.pdf
Survey on the Quality of the Civil Service Applicant Pool CS-1745a *Revised 7/2009*	CS1745a.dot	CS1745a.pdf
Training Programs Nominations - Billing CS-457 *Revised 8/2007*	CS457.dot	CS457.pdf
Unclassified Position Description CS-133 *Revised 1/2008*	CS133.dot	CS133.pdf
Vacancy Posting Security Agreement CS-1765 *Revised 7/2009*	CS1765.dot	CS1765.pdf
Work Rule for Workplace Safety Revised 8/2007	Safety.dot	Safety.pdf
Working Out of Class CS-1804 *Revised 8/2009*	CS1804.dot	CS1804.pdf
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Helpful Tips:

If you do not have Microsoft Office 97 or later version (e.g., Office 2000, XP), use the pdf version of the form.
Read the instructions before you fill out the application. The instructions contain valuable information on filling out the application.
Review the quality of printing of your form and do not submit a form where printing is incomplete, not formatted properly, or otherwise looks odd.

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How to Download and Use Civil Service Forms

If you decide to "Open the file from its current location," do not be alarmed if a "Warning" dialog box pops up indicating, "The document you are opening contains macros or customizations." All of the form templates contain macros and/or customizations from a trusted source. Therefore, select the "Enable Macros" button to proceed with opening the form template. You can then fill in the form template and print it directly from the Web.

To save a file to your computer using Microsoft Office 97 or later version (e.g., Office 2000, XP, 2003), find the form you need from the list above and double-click on the file name (e.g., CS178.dot, for a MS Word document). After you double-click on the form template name, a window may open informing you that you are about to download an item from another server. This warning will vary based on the browser you are using. Once the form template opens, you can select the "Save As" command from your "File" menu and save the form template to your template folder (e.g., "C:/Program File/MSOffice/templates").

Once you have saved the form template to your template directory, open MS Word and select the form template from the File + New dropdown menu to create a new form document. Complete the form by tabbing through the fields and entering the requested text. Use the "space bar" or mouse to select a checkbox. The forms do not need to be unprotected in order to enter information into the fields on the forms. Use the unprotect feature of the form only to reformat the actual form. Be sure to reprotect the form, if you unprotect it, before printing it, or all of the information entered into the fields will disappear when you print the form. For more detailed information on downloading and saving the templates, see the FAQs.

Instructions for Downloading and Using the PDF Format

Acrobat Reader is required to view, fill-in responses, and print a form in a PDF format. You cannot save the filled-in responses unless you have a license for Adobe Acrobat (however, you can save a copy of the form without your responses with just the "Reader"). Click on the yellow box to download a free copy of Acrobat Reader.

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The state of Michigan is an Equal Opportunity Employer
Drug Testing Policy: All persons offered employment in the classified service are required to submit to and pass a pre-employment drug test as a condition of employment.


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