Requested Leave. The Board, upon written request of a teacher, may grant a leave of absence for up to one (1) year for any reason. The leave may be with or without compensation, and with or without insurance, at the discretion of the Board.
Requested Leave a. Fringe benefits will be paid through the month following the month of the start of the leave.
b. When on an approved extended leave of over one month, an administrator may keep this insurance in effect if allowed by the insurance contract agreement by providing the school with a check or money order for the proper amount made out to the insurance company involved, or when possible, by authorizing the Board to make advance deductions.
c. All fringe benefits will be terminated after an individual contract is deemed to be null and void.
Requested Leave. (Last Working Date) (Expected Date of Return) Approved Not Approved OFFICE OF HUMAN RESOURCES RE-1J Approved Not Approved (Signature) (Date) (Board President) (Date) I, , understand that I am eligible to continue my District health insurance, at my expense, for up to one year, while on authorized leave with Montrose County School District. I understand monthly premiums must be paid by the 15th of each month or coverage will be cancelled. No further notice for premium payment will be sent. I ELECT to continue coverage (at my expense) I ELECT NOT to continue coverage Signature Date HR Department Representative Date Payroll Department Representative Date Last Name First Middle Employee ID # (from HR) Mailing Address City State Zip Code Assigned Site (School)/ Position Telephone Number (Home/Cell) Telephone Number Name Business Address Business Phone Name Business Address Business Phone I have days of leave. (Note: Leave days are the total days already accumulated and those that will accrue throughout the current contract year.) I am applying to the Catastrophic Leave Bank for number of days. My signature below constitutes my acknowledgement and permission for the Catastrophic Leave Bank Committee to obtain the health care information they need from my physician(s) in order to process my request for days from the Catastrophic Leave Bank. I understand that I may revoke this Authorization in writing at any time. However, my revocation will not apply to information already supplied by my physician(s) to the Committee. Unless I revoke my authorization in writing, this Authorization shall automatically expire 3 months from the date of my signature below. Start Date of Requested Leave: Expected Date of Return: Please check one box: ESP Licensed Name of Patient and Relationship to Employee Medical Diagnosis I certify that has been under my treatment and care and that this illness/injury, quarantine or non-elective surgery is such that it renders the employee unable to perform his/her work duties on a temporary basis or creates the medical need of assistance by employee. This employee needs approximately xxxx to attend to his or her spouse/child/legal dependent or to recuperate and return to his or her assigned duties. Date Physician’s Signature Date Physician’s Signature Effective Date of Use: Termination of Use: Days Charged to Bank: Signature of CLB Member Signature of Human Resource Representative
Requested Leave. Such payment or reimbursement is at the discretion of the district administration.
Requested Leave. 42 Up to five (5) days of paid non-accumulative teacher requested leave may be used 43 by each teacher per school year. The leave may be taken by the teacher without 44 loss of pay or other benefits, with the following provision:
45 1. Three (3) days advanced written notice shall be given to the appropriate
47 2. Teacher requested leave for the following days will be granted at the discretion 48 of the administration, and the teacher may be asked for an explanation:
49 a. The first and last two weeks of the school year.
50 b. The school day immediately before and after a holiday or vacation 51 period.
52 c. Parent-Teacher Conferences.
53 3. Personal leave may be granted provided a qualified substitute is available and 54 there are not an excessive number of teachers requesting leave on the same 55 day.
56 4. Teacher requested leave must be taken in increments of at least one-half (1/2) 57 days.
58 5. Teacher requested leave used for an emergency shall not require three (3) day 59 advanced notice as stipulated above. In such cases, the teacher must give as 60 much advanced notice as possible.
61 a. If the principal is unable to find a substitute because of short notice, 62 he/she may assign other teachers to cover the class period or periods, 63 for no more than one school day, on a basis agreeable to such staff 64 members and the principal.
