New Submission

Notice of Absence: 13.1.1 Except as provided herein, unit members shall not be absent from duty without notifying and receiving advance permission from the Superintendent, or her/his designee. 13.1.2 Notice must be given to the County Office prior to the day of absence whenever possible. Except in the event of an emergency.
Your Name*field type single line
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Your Email Address*field type single line
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Manager/Supervisor Name*field type drop-down
Manager UserNamefield type single line
Used for Workflow Routing Only
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Manager/Supervisorfield type single line
This is a hidden field just for routing in the workflow
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Are You A Teacher?*field type radio button
Are You A Teacher?Yes I'm a TeacherNo I'm NOT a Teacher
Training/Professional Development?field type radio button
Is this absence for pre-approved professional development or job related training?
Training/Professional Development?YesNo
PD / Training / Conference Titlefield type single line
Please list the name of the training or conference you are attending below:
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Beginning Leave Date*field type date
Returning From Leave Date*field type date
Substitute Name*field type single line
List all names of subs who will cover for you during this absence.
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# of Days or Hours of Leave Requestedfield type number
Assume 7 hrs = 1 full day
Type of Request*field type radio button
Type of RequestPreviously Taken Sick LeaveSick Leave (Future)Personal Necessity LeaveJury Duty LeaveBereavement LeaveLeave Without Pay/NCDBonding LeaveReproductive Loss Leave
Personal Necessity Reason*field type radio button
Personal Necessity ReasonABCDEF
Choose the appropriate reason for your request from the approved list below.
Personal Necessity Leave - Certificated Employees
13.4.1 Unit members may use up to 10 days of sick leave for personal necessity each school year.
13.4.2 Personal necessity leave includes those reasons set forth in Education Code sections 44981 and 45207.
(a) Death of a member of the immediate family when additional leave is required beyond that provided under Bereavement Leave.
(b) Accident, fire, flood, or other immediate danger involving the person or property of the unit member, or the person or property of a member of the immediate family.
(c) Appearance in court or before any administrative tribunal or litigant, party, or witness under subpoena or any order made with jurisdiction, or legal matters involving the adoption of a child.
(d) Personal emergencies which cannot reasonably be expected to be disregarded by the unit member and which necessitate his/her immediate personal attention during assigned duty hours.
(e) An illness of a member of the unit member’s immediate family.

(f) For the purpose of non-immediate family bereavement and/or scheduled events involving family members, specifically, school functions, weddings, and graduation one day shall be granted and included within existing personal necessity.
13.4.3 Leave for personal necessity may be allowed for other reasons at the discretion of the Superintendent or designee.

13.4.4 The employee shall request advance permission for personal necessity leave, except urgent situations such as the death or serious illness of a member of the immediate family or an accident involving the employee’s person or property or the person or property of a member of the immediate family. (Education Code section 44981).
Certificated Sick Leave
13.2.1 Unit members employed five (5) days per week shall be entitled to ten (10) work days’ leave of absence for illness or injury, with full pay, for each school year of service. Unit members employed fewer than five (5) days per week shall be entitled to a proportionate amount of sick leave. Sick leave may be used by the unit member for illness, injury, or quarantine of the unit member or of the member’s immediately family. Sick leave, which is not used, shall accumulate from year to year without limit.
13.12 Bereavement Leave
A unit member shall be entitled to three (3) days’ leave of absence without loss of salary in the event of the death of any member of the immediate family. If travel out of state or in excess of 300 miles one way is required, a unit member shall be entitled to a maximum of two (2) additional day’s bereavement leave. Member of the ‘immediate family” means spouse, domestic partner, child, stepchild, grandchild, parent, stepparent, mother-in-law, father-in law, son-in-law, daughter-in-law, grandparent, great grandparent, brother, sister, half-brother, half-sister, stepsibling, brother-in-law, sister-in-law, aunt, uncle, niece, nephew or first cousin (that is a child of an aunt or uncle) or cohabitant (any person living in the immediate household of the unit member).

The Superintendent or designee may grant additional bereavement leave at her/his discretion.
Jury Duty/Witness Leave
13.5.1 Unit members shall be granted leave, without loss of pay, to appear in court as a witness, other than as a litigant, or to respond to an official order from duly authorized government agencies, or to serve as a juror. Unit member shall submit “Request for Absence” forms for jury duty.
13.5.2 Any compensation, less any mileage expenses, received for appearance as a witness or from serving as a juror under this section shall be endorsed over to the TCOE so that the unit member’s compensation for any days of absence for the above purpose shall not be in excess of nor less than, her/his regular pay.
Reproductive Loss Leave - This leave allows employees to take up to 5 days of unpaid leave following a reproductive loss event. RLL works like a hybrid between bereavement and pregnancy disability leave (PDL).
What is a reproductive loss event?
Failed adoption, failed surrogacy, miscarriage, stillbirth, or unsuccessful assisted reproduction. Assisted reproduction includes procedures such as in vitro fertilization (IVF) or intrauterine insemination (IUI).
Who is eligible?
Eligible employees are defined as any person who has been employed by the employer for more than 30 days. Leave is only available to would-be parents, including the non-birthing parent.
How often can this leave be taken?
Employees can take leave for up to 5 days per event; and a maximum of 20 days in a 12-month period.
When does the leave begin?
Reproductive loss leave can begin the day of or, for a multiple-day event, the final day of a failed adoption, failed surrogacy, miscarriage, stillbirth, or an unsuccessful assisted reproduction.
Can the leave be intermittent?
Yes. The leave can be used all at once or it can be used intermittently, but it must be used within 3 months of the qualified event.
Datefield type date
Date will be captured on form submission
Additional Commentsfield type multi line
Please put in a brief explanation for this request and any relevant details.
Electronic Signature*field type signature
Manager Emailfield type single line
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Certificated Leave Request