Forms

The purpose of this form is to ensure compliance with LCSC and Idaho State Board of Education (SBOE) professional consulting and conflict of interest /ethical conduct policies. By signing the statement annually, you acknowledge you are responsible and accountable for the information set forth in LCSC Professional Consulting and Additional Workload Policy, #3.132, LCSC Code of Ethical Conduct Policy, #3.101, and SBOE Conflict of Interest and Ethical Conduct Policy, Section II, Subsection Q.

Professional Consulting / Conflict of Interest Statement

Please visit the new Hiring Process page!

The Family and Medical Leave Act (FMLA) is a federal law which entitles eligible employees to unpaid, job protected leave, under qualifying circumstances, as follows: (1) for a qualifying health condition of the employee or a family member; (2) for the birth or adoption of a child; and (3) for specific purposes to family members of qualifying military service members. Employees may, at their discretion, elect to use accrued vacation leave, sick leave, and/or compensatory balances concurrently while on FMLA leave (as appropriate).

To qualify for FMLA leave, the employee must meet eligibility criteria, must submit a written request, and upon return to work must provide a medical release (as appropriate).

In the event an employee does not request FMLA leave for time off work for a qualifying health condition, LCSC will designate the employee’s absence as FMLA leave (as appropriate).

Department of Human Resources FMLA Policy

FMLA Leave Request (completed by employee)

Notice of Eligibility & Right and Responsibilities (completed by employer)

Designation Notice (completed by employer)

Certification of Health Care Provider for Employee

Certification of Health Care Provider for Family Member's Serious Health Condition

For institutional funds, in lieu of completing the MOA on every payment-in-addition, a document that includes the following information may be accepted:

  1. Date of agreement
  2. Employee name
  3. Title for job to be performed
  4. Department
  5. Payment amount
  6. Dates of work to be performed
  7. Date to be paid
  8. Description of service/work performed
  9. Employee Signature and date
  10. Supervisor Signature and date

Please visit the Human Resources Performance Management website. 

This form is used for student and irregular help employees (new hire, hourly rate change, separation, etc).

Information on Irregular Help working hours:

Please review this flowchart if you are wanting to:

  • Change the title of a position;
  • Make changes to a cost center;
  • Make salary changes to a position;
  • Make FTE changes to a position; or
  • Have department changes.

This is used to make changes to Classified Staff classifications due to change in job responsibilities, etc.

Professional Staff and Faculty: you have the option to choose between a 403B Tax Shelter Plan and the 457 Deferred Compensation Plan.  Which is better for you? Check out this comparison chart, or schedule an appointment with your ORP representative to determine which is best for you. 

Classified Staff: you can choose to put away additional funds into a PERSI Choice 401(k) Plan.  

For additional information, please contact hr@lcsc.edu

Therapy animal handlers must complete the Therapy Animal Agreement form. This form must be signed by the department head or supervisor and returned to the Human Resource Services office at least one week prior to the animal’s arrival on campus.

Please note the deadline to have approval on fee-waiver forms is the Friday prior to each semester's start.

Employee Registration Request

  1. The Employee Registration Request must be completed prior to registering for classes.
  2. Eligible employees may register for a maximum of seven (7) credits in a semester and in the summer session under the terms of this benefit at LC State.  All other Idaho institutions allow for six (6) credits in the spring and fall, and three (3) in the summer.
  3. Eligible spouses and retirees may register for a maximum of six (6) credits in a semester or three (3) credits in the summer.
  4. The employee’s job has priority. In the event of conflicts between requests to take classes during scheduled working hours and the department’s ability to provide services, the supervisor has the authority and responsibility to approve, modify or deny the request.

Employee Registration Request

Dependent Child Fee Waiver

  1. The employee must be an LC State employee who has completed at least six (6) months of benefit-eligible service with the college and who is scheduled to work at least 20 hours per week.
  2. “Dependent” is defined as an unmarried child of an employee of LC State under the age of 26 as of the first day of the semester. A child is defined as a son, daughter, stepchild, adopted child, or foster child.
  3. The discount for a dependent is a 50% reduction in current resident and nonresident tuition and fees. No other fees are waived by this benefit. Any applicable course, lab and additional fees will apply.
  4. This benefit does not apply to post-bachelor courses, non-credit courses, summer session courses, continuing education courses or courses delivered by institutions other than LC State.
  5. The dependent must be an admitted student who has met all normal academic requirements for the courses delivered by LC State.
  6. The discount applies to tuition and fees for either a part-time schedule or a regular full-time class load, as defined by the college. Overload credits are not eligible for the dependent fee discount.
  7. The dependent fee discount may be used for a maximum of eight (8)  semesters per dependent (whether part-time or full-time student).
  8. A cumulative GPA of 2.0 or above must be maintained in order to be eligible for the dependent fee discount in subsequent semesters.
  9. Two dependent fee discounts are allowed per semester per family. If both parents work for the college, only two dependents will be permitted to utilize the dependent fee discount.
  10. If the employee's appointment ends during and academic period for which the employee, spouse, or dependent is registered for academic work under this policy, eligibility for tuition and fee discounts expire at the end of the academic period.

Dependent Child Fee Waiver Form

Submit this form along with your itemized receipt to VSP for out-of-network vision reimbursement or visit the Benefits & Claim section on VSP's website to submit a claim.

  • If you prefer to submit your claim via mail, please contact Member Services at 800-877-7195 to obtain a VSP Member Reimbursement Form.

Anytime an industrial-related injury occurs, the employee and supervisor must follow this flowchart and return all documents to Human Resource Services within 10 days of injury: