Dear Dupont Team Members:
As team members, family members and neighbors we know your time is valuable. In order to continue to support work/life balance, we are pleased to offer the following downloadable forms. We want you to have access to them whenever and wherever you need them. Please let us know if there is anything else that you would like to see listed. Thank you for your continued dedication to our hospital and our community.

Sincerely,
Stacy Junk
Team Leader

The forms contained in this section are intended for use by Dupont Hospital Team Members.

To view these documents, you'll need the free Adobe Acrobat Reader.

TEAM MEMBER INFORMATION:

• Service Excellence Standards of Performance Handbook
• 2009 Team Member Benefits Summary
• Team Member Inservice / Education Record
• Tuition Reimbursement Procedures

BENEFITS

• Concierge Connection

PAYROLL AND TAX FORMS:

• State of Indiana WH-4 Form: Employee's Withholding Exemption and County Status Certificate
• State of Indiana W-4 Form (2010)
  
• Ohio State Employee's Withholding Exemption Certificate
• Payroll Direct Deposit Authorization

JOB APPLICANT:

• Pre-Screening Notice and Certification Request Form
• Employment Eligibility Verification
• WOTC Tax Credit Forms