Request for Longevity Pay

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Please fill out this form when you are eligible for longevity pay based on the terms of your employment or collectively-bargained agreement

Your First and Last Name*

Answer required for "Your First and Last Name"

Your LASID Number

Answer required for "Your LASID Number"

Your Position*

Answer required for "Your Position"

Teacher

Administrative Assistant

Paraprofessional

Administrator

Other

Number of Years of Employment You Have Completed*

Answer required for "Number of Years of Employment You Have Completed"

40-Plus

The information provided here is accurate and up to date and was not filled out by anyone other than the individual named at the top of this form*

Answer required for "The information provided here is accurate and up to date and was not filled out by anyone other than the individual named at the top of this form"

Yes

Please fix the highlighted areas below before submitting.

Request for Longevity Pay