Human Resources Forms

Collections of Human Resources Forms 

• Employment Forms and Procedures
• Employee Tuition Exemption/Reduction Forms and Procedures
• Overtime/Compensatory Leave Forms and Procedures
• Americans with Disabilities Act (ADA) Forms (Office of Human Resources)
• Performance Evaluations Forms and Procedures

Individual Human Resources Forms

• ADA - Request for Reasonable Accommodation Form
• ADA- Medical Inquiry Form (Reasonable Accommodation Questionnaire)
• Adjunct Faculty Agreement Form
• Application for Employment (Online)
• Application for Employment Form (Paper Form for Adjunct Faculty Only)
• Change of Address/Name Form (for all Delgado employees)
• Classified Employees Performance Evaluation System (PES)
• Classified Full-Time Position Description (Word)
• Classified Part-Time WAE Position Description (Word)
• Classified Staff Grievance Form (SF16)
  
• Confidentiality Agreement Form (HR Office Form - Employee/Contractor/Student/Volunteer)
• COVID-19 Temporary Virtual Work Agreement for Non-Faculty Employees Effective 1/3/22 - 1/30/22
• Direct Deposit Enrollment Authorization Form (Form BAA-K01/001)
• Direct Deposit Waiver Request Form (Form BAA-K01/002)
• Disclosure of Outside Employment Requiring Approval of Chancellor or System President (LCTCS Form "B", Word Version)
• Disclosure of Outside Employment Requiring Approval of Chancellor or System President (LCTCS Form "B", PDF Version)
• Disclosure of Outside Employment Requiring Approval of the Vice Chancellor (LCTCS Form "A", PDF Version)
• Disclosure of Outside Employment Requiring Approval of the Vice Chancellor (LCTCS Form "A", Word Version)
• Documentation of Warning (Form 2130/001) - Suggested Template
• Emergency Contact Form
• Employee Exit Checklist Procedures
• Employee Request for Released Time to Attend Class (Form 1412/001)
• Employee Request for Tuition Exemption (Form 1412/002)
• Employee Request for Tuition Reduction (1412/003)
• Employee Withholding Allowance Certificate - Federal (W-4)
• Employee Withholding Exemption Certificate - State of Louisiana (L-4)
• Employment Eligibility Verification Form (I-9)
• End-of-Semester Checkout Form (Form 2122/002)
• Exemption from the Classified Service - Request (Part-Time Unclassified)
• Extra Service Agreement (Form 3242/003)
• Federal Ethnicity and Race Reporting Form
• FFCRA - Request for Families First Coronavirus Response Act Leave Form
• FFCRA - Child-School List Form
• FMLA - Certification of Health Care Provider for Employee's Serious Health Condition
• FMLA - Certification of Health Care Provider for Family Member's Serious Health Condition
• FMLA - Certification of Qualifying Exigency for Military Family Leave
• FMLA - Certification for Serious Injury or Illness of Covered Service Member - Military Family Leave
• FMLA - Certification of Serious Injury or Illness of a Veteran for Military Caregiver Leave
• FMLA - Designation Notice
• FMLA - Notice of Eligibility and Rights & Responsibilities
• FMLA - Request for Family and Medical Leave Act (FMLA) Form 
• Full-Time Faculty Agreement Form 
• Full-Time Faculty Agreement ADDENDUM Form
• Full-Time Non-Teaching Faculty Agreement Form
• LASERS Change of Address Form
• LCTCS Parental Leave Certification Form
• Leave Request Form (Form 2400/001)
• Louisiana Workman's Compensation Second Injury Board Post Hire/Conditional Job Offer Knowledge Questionnaire
• OGB (Office of Group Benefits) Enrollment/Change Form
• OGB (Office of Group Benefits) Flexible Benefits Plan - Flexible Spending Arrangement Enrollment Form
• OGB (Office of Group Benefits) Health Savings Account (HSA) Form
• Overtime/Compensatory Leave Approval Form (Form 2400/005)
• Overtime - Statement of Agreement or Understanding for Classified Employee Compensation for Overtime Work
• Parental Leave Certification Form (LCTCS Form)
• Part-Time Agreement Form
• Part-Time and Extra Services Agreement Form
• Part-Time Temporary Agreement Form
• Personnel Action Form (Form 2100/002)
• Position Control Form (Form 2100/001)
• Public Records Request Authorization - Delgado Human Resources
• Recoupment of Overpayments Statement of Understanding Form (LCTCS Form)
• Reference Check Form
• Request for Direct Deposit Waiver (Office of State Uniform Payroll UPR/F46)
• Request for Released Time (Form 2420/001)
• Salary Deferred-Payback Option Form
• Shared Sick Leave Donation Form (Form AD-007/01) (*See Shared Sick Leave Program Policy)
• Shared Sick Leave Application Form (Form AD-007/02) (*See Shared Sick Leave Program Policy)
• Statement of Agreement or Understanding for Classified Employee Compensation for Overtime Work
• Summer Schedule Temporary Virtual Work Agreement for Full-Time, Non-Faculty Employees Effective 5/30/22 - 6/30/22
• Summer Service Employment Form for Nine-Month Full-Time Faculty (Form 2123/001)
  -- Summer Session Pay Scale
• Telephone Reference Check Sample Form
• TRSL Enrollment Application/Notification Form
• TRSL Name Change Request Form
•  Unclassified Employee Problem Solving Form (Form 2534/014)
• Unclassified Faculty/Staff Position Description Form (Form 2200/005)
• Unclassified Staff Performance Evaluation and Planning Form (LCTCS Form)
• Verification of Employment Form
• Violence Incident Statement
• Voluntary Self-Identification of Disability Form - LCTCS Form