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DIVISION OF ADMINISTRATION LA CARE PROGRAM CARDHOLDER ENROLLMENT FORM REVISED 04/27/04 NEW CHANGE CARDHOLDER ACCOUNT # DELETE CARDHOLDER ACCOUNT # -------------------------------------------------------------------------------------------------------------------------------------------Section
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La carte program is a program that allows individuals to select specific items or services from a list.
Individuals who want to benefit from the flexibility of choosing specific items or services are required to file la carte program.
You can fill out la carte program by selecting the items or services you want from the available list and submitting the form with your choices.
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The information reported on la carte program includes the specific items or services selected by the individual.
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