Need HR Help?

For contact information or more information about HR, click here.

Deaf or Hard of Hearing? Duke Human Resources
705 Broad St. Box 90496
Durham, NC 27705
Phone: (919) 684-5600
Para informacion en espanol?

Kiel Program Application Form

To request a donation from the Kiel Program, just complete a Recipient Application (PDF), along with a Certification of Health Care Provider Form*. The Recipient Form is submitted your supervisor for documentation and forwarded to Benefits for processing. The Kiel Program Application Form should be sent to Duke Benefits at 705 Broad Street (Box 90502), Durham, NC 27705 (fax number 919-681-8774).

In order to ensure that submitted application forms are processed in time for payroll cutoff schedules, all documents (applications, certifications of health care providers, and donations) will need to be submitted to the Benefits Department (fax 919-681-8774) no later than noon on the cutoff dates listed here. Final approval by Benefits is required.

*See also the Certification of Health Care Provider Forms for employees and/or family members.

Form Name Format
Kiel Program Application Form PDF
Kiel Program Application Form Word
Some Duke HR forms may require you to list your Duke Unique ID.  If you do not know or are unsure of your Duke Unique ID, you can look it up here.
Some forms available on this web site are in Adobe Portable Document Format (PDF).  You will need Adobe Acrobat Reader to view and print these forms.