Org. Code                         NEW EMPLOYEE (Credentials Attached)
         

    Campus Code                         PART-TIME AGREEMENT               RETURNING EMPLOYEE

     
    Position #                     FULL TIME OVERLOAD



    Tracking No.:              Revised or Canceled Agreement?   Canceled Revised     
    Date:                            One-Time Pay? Yes Grant Agreement? Yes
                         
    This form must be completed by the Dean of the division and approved by appropriate College officials before processing and/or payment.


    Name:                         Last 4 Digits SS#:   Banner ID#:
                                                                                                                                                              (Full SS# for new hires):  


    Address:

               Street Address           City         State    Zip Code

    Phone (home):                Gender: Date of Birth:
     


     
    (office):                               Personal Email:            
    (New employees only)
    Retired from a La. Retirement System?          Yes No
    *Member of a La. Retirement System? TRSL (Teachers) VALIC VOYA (ING)   
    TIAA-CREF LASERS None

     
    *My signature at the bottom of this form acknowledges the following. As an active employee of Delgado Community College I agree to notify
    the Human Resources and Payroll Departments upon my date of retirement from any state retirement system. I am aware that re-employment during the 12 months immediately following my retirement may result in a suspension of benefits.
     

    AGREEMENT INFORMATION


    Start: End:
                            
    Effective Dates:      Semester/Session: Fall Spring
    Summer
     
                                                 
    Division: Timesheet                 
      
     
    Approver:
             
    For Hourly Agreements Only:Hourly Rate: Estimated Number Hours per Week: 
     
     

    Class
         		Title DCC
    FTE         		ACC +
    Off Hrs
    		Hrs/Pay
         		Hrs/Day
         		Days/Time Credit
    Hours         		Contact Hours
         		Dollar Amount
                       
                       
                       
                       
                       
     
    TOTALS:
    		               


    Are you working at another LCTCS institution during the period of this agreement? Yes   No


    If Yes, Name of Institution: How many hours/week are you working at that institution?
     


    I also understand that I am responsible for submitting a timesheet or completing web-time entry in order to be paid on a timely basis.

     
    For part-time teaching agreements, it is understood that the amount paid per course includes all time and effort required in preparing instructional materials, providing instructional services, keeping and reporting class records, submitting final grades, and completing all required/mandated employee training/professional development, as applicable. It is further understood that the Business Office will make payments according to the latest approved part-time agreement pay schedule and that final payment will not be made until final grades and records and a completed End-of-Semester Checkout Form are submitted. I also understand that this agreement is null and void if the College cancels the course section. I understand that as a part-time faculty member I am required to be available on a regularly-scheduled basis for out-of-class conferences with students for a minimum of one-half hour per week per course. I further understand that conference periods must be scheduled at times that facilitate student access to instructors and must be approved by the Dean of the division.
     

     
    For all part-time agreements, it is understood that, in the event that I must be absent from duty, I am responsible for arranging for a qualified substitute, as applicable, who is approved by the Dean of the division. If these arrangements are not made, a substitute may be selected by the College and paid at the usual hourly rate and that amount will be deducted from the agreed upon pay amount.
     

    I further understand that in the event this agreement is processed following the initial pay period deadline(s), my full agreed upon pay will be distributed across the remaining pay periods through the agreement’s ending date. I also understand that I am responsible for documenting time worked in order to be paid on a timely basis.
     
    * Employee’s Agreement Signature: __________________________________________ Date: ____________________
     
    I CERTIFY THAT THE CLASS SCHEDULE, AGREEMENT HOURS,  NON-CREDIT ONLY - I CERTIFY THAT THE AGREEMENT HOURS, AND
    AND AMOUNT PER COURSE ARE TRUE AND CORRECT    :  AMOUNT PER ASSIGNMENT/COURSE ARE TRUE AND CORRECT:
     
    _________________________________________________  ___________________________________________________
    Division Dean    Date                      Director, Workforce Development   Date
         
    CREDENTIALS VERIFICATION (for new employees only):     ___________________________________________________
     
    _________________________________________________   Vice Chancellor for Workforce Development &Technical Education Date
    Vice Chancellor for Academic Affairs Date                   Form 3242/002 (1/19)

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