Submit the following document(s) to your supervisor, manager or bookkeeper and they will forward them to Human resources:

• A completed LOA Notification form (MIS #09.11)
• A completed Application for Family and Medical Leave (FMLA) (MIS #09.78) (see FMLA Information below).
• For a medical leave, a doctor's note with "Beginning and Ending Dates" for your medical leave of absence.
  • A Medical Certification Slip (MIS #09.49) may be given to your Physician if their office does not provide a doctor's note.

Please Note: The "Beginning and Ending Dates" on the Doctor's Note, LOA Notification and FMLA Application MUST match.

Employees who apply for leave under the FMLA guidelines may be eligible if they have worked for at least 12 months, and worked for 1,250 hours over the previous 12 months. All employees on leave under FMLA guidelines may continue to receive School Board insurance benefits for the duration of the approved leave (up to 12 weeks). If the employee does not qualify for FMLA benefits, the employee is responsible for insurance premiums.

• LOA Questions: Call Human Resources at 471-5735 or 471-5736
• Insurance Questions: Call Insurance & Benefits at 471-5669 before applying for any leave of absence