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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 97 and XP 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).

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 WebTeam.
Revised: April, 2008

Form Number and Name	Microsoft Office 97 and XP	PDF
Exam 2002 Entry-Level Law Enforcement Examination Application *Revised 8/2007*	App2002.dot	App2002.pdf
Exam 2012 State Police Sergeants Examination Application (state employees only) *Revised 8/2007*	App2012.dot	App2012.pdf
Exam 4012 Entry-Level Security Examination Application *Revised 8/2007*	App4012.dot	App4012.pdf
Exam 4081 Corrections Nonprofessional Supervisors Examination Application *Revised 8/2007*	App4081.dot	App4081.pdf
Exam 5029 Administrative Support Examination Application (state employees only) *Revised 8/2007*	App5029.dot	App5029.pdf
Exam 9031 Supervisory Examination Application *Revised 8/2007*	App9031.dot	App9031.pdf
CS-100 Grievance Form *Revised 1/2008*	CS100.dot	CS100.pdf
CS-133 Unclassified Position Description *Revised 1/2008*	CS133.dot	CS133.pdf
CS-140 Final Compensation Beneficiary Designation Revised 8/2007	CS140.dot	CS140.pdf
CS-140a Final Compensation Beneficiary Affidavit *Revised 8/2007*	CS140a.dot	CS140a.pdf
CS-212a Technical Classification Complaint Revised 1/2008	CS212a.dot	CS212a.pdf
CS-212b Technical Qualification Complaint Revised 1/2008	CS212b.dot	CS212b.pdf
CS-212c Technical Disbursement Complaints *Revised 1/2008*	CS212c.dot	CS212c.pdf
CS-212d Technical Appointment Complaint *Revised 1/2008*	CS212d.dot	CS212d.pdf
CS-214 Civil Service Position Description Instructions for CS-214.doc Instructions for CS-214.pdf Revised 8/2007	CS214.dot	CS214.pdf
CS-424 Student Program Application *Revised 1/2008*	CS424.dot	CS424.pdf
CS-630 Application for the Twelve-Month Trial Appointment Program for Handicappers *Revised 1/2008*	CS630.dot	CS630.pdf
CS-944 Application for Persons with Disabilities and Request for Reasonable Accommodation in the Written Examination Process *Revised 4/2008*	CS944.dot	CS944.pdf
CS-1668 Disability Accommodation Request by Employee CS-1668 Text Only Version *Revised 6/2006*	CS1668.dot	CS1668.pdf
CS-1706 Adding Names to Applicant Pools for Examinations Already Taken and Passed *Revised 8/2007*	CS1706.dot	CS1706.pdf
CS-1717 Life Insurance and Accidental Duty Death Enrollment and Beneficiary Form This Form is for Judicial State Employees Use Only *Revised 11/2007*	CS1717.dot	CS1717.pdf
CS-1740 Proof of Service to Other Parties to the Employment Relations Board *Revised 8/2007*	CS1740.dot	CS1740.pdf
CS-1743 Application for Leave to Appeal to the Employment Relations Board *Revised 3/2008*	CS1743.dot	CS1743.pdf
CS-1747 Request to Order Witnesses to Appear and/or Produce Documents *Revised 8/2007*	CS1747.dot	CS1747.pdf
CS-1754 Brief in Response to Application for Leave to Appeal to the Employment Relations Board *Revised 8/2007*	CS1754.dot	CS1754.pdf
CS-1756 Claim of Appeal as of Right to the Employment Relations Board Revised 8/2007	CS1756.dot	CS1756.pdf
CS-1759 Technical Appointment Complaint Proof of Service to Appointing Authority To be used for Technical Appointment Complaints Only Revised 8/2007	CS1759.dot	CS1759.pdf
CS-1760 Petition for Election Revised 8/2007	CS1760.dot	CS1760.pdf
CS-1766 Notification by Employee/Retiree of Qualifying Event Revised 8/2007	CS1766.dot	CS1766.pdf
CS-1767 Continuation of Insurance Application This Form is for Employee Benefits, Human Resource Offices, and Retirement Use Only Revised 8/2007	CS1767.dot	CS1767.pdf
CS-1771 Dependent Eligibility Verification Revised 1/2008	CS1771.dot	CS1771.pdf
CS-1773 Health Care Flexible Spending Account Mid-Year Enrollment Revised 11/2007	CS1773.dot	CS1773.pdf
CS-1774 Dependent Care Flexible Spending Account Mid-Year Enrollment Revised 11/2007	CS1774.dot	CS1774.pdf
CS-1776 Parking Account Enrollment Revised 8/2007	CS1776.dot	CS1776.pdf
CS-1777 Benefit Enrollment Application Revised 8/2007	CS1777.dot	CS1777.pdf
CS-1779 Parking Account Reimbursement Revised 8/2007	CS1779.dot	CS1779.pdf
CS-1781 Beneficiary Designation Change Revised 8/2007	CS1781.dot	CS1781.pdf
CS-1782 HIPAA Privacy Complaint Form Revised 8/2007	CS1782.dot	CS1782.pdf
CS-1783 Disclosure of Interest Revised 4/2007	CS1783.dot	CS1783.pdf
CS-1784 Flexible Spending Accounts Life Event/Election Change Revised 11/2007	CS1784.dot	CS1784.pdf
CS-1786 HIPAA Disclosure Authorization Revised 5/2004	CS1786.dot	CS1786.pdf
CS-1789 Certification of Health Care Provider Revised 8/2007	CS1789.dot	CS1789.pdf
CS-1790 FMLA Employee Request and Employer Response *Revised 8/2007*	CS1790.dot	CS1790.pdf
CS-1791 Vets Preference Registration Form *Revised 4/2008*	CS1791.dot	CS1791.pdf
CS-1793 Attachment to CS-1743 *Revised 8/2007*	CS1793.dot	CS1793.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 Number and Name	Microsoft Office 97 and XP Format	PDF Format
Discriminatory Harassment Work Rule Revised 8/2007	Harrass.dot	Harrass.pdf
Work Rule for Workplace Safety Revised 8/2007	Safety.dot	Safety.pdf
CS-133 Unclassified Position Description *Revised 1/2008*	CS133.dot	CS133.pdf
CS-153 Request for Credential Review Credential Review Procedures.pdf Prescreen Procedures.pdf *Revised 1/2008*	CS153.dot	CS153.pdf
CS-214 Civil Service Position Description Instructions for CS-214.doc Instructions for CS-214.pdf *Revised 8/2007*	CS214.dot	CS214.pdf
CS-301 Employee Departure Report *Revised 8/2007*	CS301.dot	CS301.pdf
CS-314 Oath of Office Revised 8/2007	CS314.dot	CS314.pdf
CS-375 Interim Employee Rating *Revised 8/2007*	CS375.dot	CS375.pdf
CS-457 Training Programs Nominations - Billing *Revised 8/2007*	CS457.dot	CS457.pdf
CS-1500 Request for Employment List Extension *Revised 1/2008*	CS1500.dot	CS1500.pdf
CS-1627 Appointing Authority's Comments on Technical Classification Complaint *Revised 8/2007*	CS1627.dot	CS1627.pdf
CS-1669 Response to Disability Accommodation Request CS-1669 Text Only Version Revised 8/2007	CS1669.dot	CS1669.pdf
CS-1670 Evaluation of Disability Accommodation CS-1670 Text Only Version Revised 8/2007	CS1670.dot	CS1670.pdf
CS-1704 Request for Prior Employment History *Revised 1/2008*	CS1704.dot	CS1704.pdf
CS-1705 Employment History File Correction Request *Revised 1/2008*	CS1705.dot	CS1705.pdf
CS-1719 Group Four and Senior Executive Service Performance Management and Competency Rating Form 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 8/2007*	CS1719.dot	CS1719.pdf
CS-1720 Senior Executive Service Limited-Term Employment Agreement *Revised 8/2007*	CS1720.dot	CS1720.pdf
CS-1738 Senior Executive Management Assistant Service (SEMAS) Limited-Term Employment Agreement *Revised 8/2007*	CS1738.dot	CS1738.pdf
CS-1745a Survey on the Quality of the Civil Service Applicant Pool Revised 1/2008	CS1745a.dot	CS1745a.pdf
CS-1745b Survey on the Quality of the Agency Candidate Pool Revised 1/2008	CS1745b.dot	CS1745b.pdf
CS-1748 Agency Training Coordinators Security Agreement *Revised 8/2007*	CS1748.dot	CS1748.pdf
CS-1750 Group One Employees Performance Management and Competency Evaluation Form Group One Behaviorally Anchored Rating Scales.doc Group One Behaviorally Anchored Rating Scales.pdf *Revised 8/2007*	CS1750.dot	CS1750.pdf
CS-1751 Group Two Employees Performance Management and Competency Evaluation Form Group Two Behaviorally Anchored Rating Scales.doc Group Two Behaviorally Anchored Rating Scales. pdf *Revised 8/2007*	CS1751.dot	CS1751.pdf
CS-1752 Group Three Supervisors Performance Management and Competency Rating Form Group Three Supervisor Competencies Behaviorally Anchored Rating Scales.pdf Group Three Supervisor Competencies Behaviorally Anchored Rating Scales.doc *Revised 8/2007*	CS1752.dot	CS1752.pdf
CS-1753 Agency Candidate Credential Review Certifications *Revised 1/2008*	CS1753.dot	CS1753.pdf
CS-1755 Information Technology Programmer/Analyst Trainee Program Appointment Agreement Revised 8/2007	CS1755.dot	CS1755.pdf
CS-1758 Position Recoding Worksheet Instructions for CS-1758.doc Instructions for CS-1758.pdf Revised 1/2008	CS1758.dot	CS1758.pdf
CS-1761 Group Three Managers Performance Management and Competency Rating Form Group Three Managers Competency Rating Scales.dot Group Three Managers Competency Ratings Scales.pdf Revised 8/2007	CS1761.dot	CS1761.pdf
CS-1762 Assistant Attorney General Performance Management and Competency Rating Form Attorney General Competency Model.doc Attorney General Compentency Model.pdf Revised 8/2007	CS1762.dot	CS1762.pdf
CS-1763 Information Technology Position Evaluation Worksheet Revised 1/2008	CS1763.dot	CS1763.pdf
CS-1764 Training Requests Revised 8/2007	CS1764.dot	CS1764.pdf
CS-1765 Vacancy Posting Security Agreement Revised 1/2008	CS1765.dot	CS1765.pdf
CS-1785 Employee Personal Data This Form is for Human Resource Offices Use Only Revised 8/2007	CS1785.dot	CS1785.pdf
CS-1787 Family Medical Leave of Absence Form This Form is for Employee Benefits and Human Resource Offices Use Only Revised 3/2008	CS1787.dot	CS1787.pdf
CS-1788 Plan C Leave of Absence Form This Form is for Employee Benefits and Human Resource Offices Use Only Revised 8/2007	CS1788.dot	CS1788.pdf
CS-1792 State Police Performance Management and Competency Rating Form Competency and Rating Scales for State Police Troopers and Sergeants.doc Competency and Rating Scales for State Police Troopers and Sergeants.pdf *Revised 8/2007*	CS1792.dot	CS1792.pdf
CS-1795 Position Request Revised 8/2007	CS1795.dot	CS1795.pdf
CS-1796 Identification of Priority Programs *New 7/2007*	CS1796.dot	CS1796.pdf
CS-1797 Priority Programs and Human Capital Alignment *New 7/2007*	CS1797.dot	CS1797.pdf
CS-1798 Position Impact Risk Assessment *New 7/2007*	CS1798.dot	CS1798.pdf
CS-1799 Position Impact Risk Assessment Description *New 7/2007*	CS1799.dot	CS1799.pdf
CS-1800 Position Risk Assessment Attrition Factor *New 7/2007*	CS1800.dot	CS1800.pdf
CS-1801 Position Success Profile *New 7/2007*	CS1801.dot	CS1801.pdf
CS-1802 Position Success Profile-Group 2 *New 7/2007*	CS1802.dot	CS1802.pdf
CS-1803 Position Bench Strength Assessment *New 7/2007*	CS1803.dot	CS1803.pdf
CS-1804 Working Out of Class New 7/2007	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), 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.


	Related Content
•	MI HR Gateway
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•	Detroit Regional Office
•	Administrative Support Exam Scheduler
•	State Employee Military Leave
•	Veterans Preference Information