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Click ‘Get Form’ to open the FMLA request form in the editor.
Begin by filling in your personal information, including your name, social security number, address, personnel number, and daytime telephone number. Ensure all fields are completed accurately to avoid processing delays.
Select the reason for your leave by checking the appropriate box. Options include Family Leave (Maternity, Adoption or Foster Care, Military Family Leave) or Medical Leave (Illness of Self or Family Member).
Indicate the dates for your leave by entering the start and end dates along with the total number of days requested. Specify how many paid and unpaid days will be used.
Provide a brief explanation for your leave request in the designated section. This is mandatory for processing.
Sign and date the form at the bottom. Remember that your signature indicates understanding of the terms regarding return to work.
Once completed, submit your application as instructed. Ensure that any required documentation is attached before forwarding it to the Leaves Department.
Start using our platform today to streamline your FMLA request process effortlessly!
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Fact Sheet #28S: Rules for Certain School Employees
The Family and Medical Leave Act (FMLA) provides job-protected leave from work for family and medical reasons. This fact sheet explains rules for using FMLARead more
Broward offers Paid Parental Leave that runs concurrently with FMLA use of maternity/paternity reasons. That means the first 20 duty days of the maximum 12Read more
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