• Process to Request a Leave of Absence:

    A request for leave of 10 days or more (excluding annual or personal leave) requires the submission of a Request for an Approved Leave of Absence form.

    Leave Request Process:

    Employee's Responsibilities:

    1. Please read the Request for an Approved Leave of Absence Form thoroughly, complete and sign.

    2. Submit the form to your Principal/Supervisor for signature at least 30 days prior to the leave start date.

    3. Refer to the employee handbook/negotiated agreement regarding leaves of absences. Family Medical Leave will run concurrently with all qualified paid/unpaid leaves.

    4. Documentation specific to the type of leave being requested must be submitted to the Benefits Office in Human Resources. See the chart below for further information.

    Reference Documents: Family and Medical Leave Act (FMLA) Board Policy and the FMLA Procedures.

    Type of Leave Additional Information Documentation Required
    Disability due to Childbirth*


    Normal disability period following childbirth is 6 weeks for normal delivery or 8 weeks for C-section


    Submit a doctor's note with expected due date at least 30 days in advance,
    Short Term Childcare Leave* Leave without pay (including Paternity and Adoption Leave) immediately following a birth or adoption of a child for 12 weeks or less as allowed under FMLA

    Paternity requests, submit form WH-380-F Certification of Health Care Provider for Family Member's Serious Health Condition.

    Adoption Leave requests, submit a copy of the legal adoption papers.

    Personal Illness*  


    Submit form WH-380-E Certification of Health Care Provider for Employee's Serious Health Condition.


    Illness in Family  


    Submit form WH-380-F Certification of Health Care Provider for Family Member's Serious Health Condition  including dates of absence, explanation, and family member's relationship to employee.


    Military Leave   Submit copy of official orders.
    Educational Leave


    Leave without pay - refer to the section titled Further Study and Education in the Negotiated Agreement for further details


    Submit acceptance letter and intended courses/credits (per semester).
    Workers' Compensation  


    No documentation required with submission of Leave Request Form. If documentation is needed, the Benefits Office will contact the employee.


     Other   Attach a detailed explanation of reason for request.

    * If you wish to add your child to your healthcare coverage, you will need to complete your request in the Benelogic System within 30 days of the birth of the child, adoption or family status change for coverage to be effective.