Form used to enroll or request a change with Louisiana Office of Group Benefits (OGB)

Voluntary Self-Identification ADA Form

In accordance with LCTCS Policy 6.018, this LCTCS Form adapted for Delgado is used annually only when the outside employment disclosed in Form A also specifically requires approval of the Delgado Chancellor or the LCTCS System President for the specific circumstances as described in the policy.

WORD Version - In accordance with LCTCS Policy 6.018, includes LCTCS Form adapted for Delgado, which is used for all outside employment disclosures requiring approval of Delgado Chancellor or the LCTCS System President

WORD Version - In accordance with LCTCS Policy 6.018, LCTCS Form adapted for Delgado, which is used for all outside employment disclosures requiring approval of the Vice Chancellor

In accordance with LCTCS Policy 6.018, this LCTCS Form adapted for Delgado is used by employees on an annual basis to disclose all outside employment and requires approval of the appropriate Vice Chancellor/ Executive Dean.

This form is required for all internal transfers, separations, and changes in salary or classification.