Faculty Request for Payment

Faculty Request for Payment
First Name
Last Name
LCC E-mail*
Banner ID*
To Locate your banner ID: Login to MYLCC, click the profile tab, Check the 'My Banner ID' box
FOAPAL If Known
Department*
CIT - Primary Assignment*
Trades - Primary Assignment*
PSC - Primary Assignment*
Transportation - Primary Assignment*
Manufacturing - Primary Assignment*
Work Activity 1
Work Activity 1: Date*

MonthDayYear
Work Activity 1: Time*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Work Activity 1: Details - Please include a description of work:*
Work Activity 1: Attach Documents if needed

Cancelof
Add a second work activity?*

YesNo
Work Activity 2
Work Activity 2: Date*

MonthDayYear
Work Activity 2: Time*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Work Activity 2: Details - Please include a description of work:*
Work Activity 2: Attach Documents if needed

Cancelof
Add a third work activity?*

YesNo
Work Activity 3
Work Activity 3: Date*

MonthDayYear
Work Activity 3: Time*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Work Activity 3: Details - Please include a description of work:*
Work Activity 3: Attach Documents if needed

Cancelof
Add a fourth work activity?*

YesNo
Work Activity 4
Work Activity 4: Date*

MonthDayYear
Work Activity 4: Time*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Work Activity 4: Details - Please include a description of work:*
Work Activity 4: Attach Documents if needed

Cancelof
Add a fifth work activity?*

YesNo
Work Activity 5
Work Activity 5: Date*

MonthDayYear
Work Activity 5: Time*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Work Activity 5: Details - Please include a description of work:*
Work Activity 5: Attach Documents if needed

Cancelof
If you need to submit more than 5 work activities, please submit and fill out additional form(s).
Should be Empty:

Faculty Request for Payment

Work Activity 1

Work Activity 2

Work Activity 3

Work Activity 4

Work Activity 5