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  • This Task has been designed for use by all roles. For all roles

In accordance with the Family and Medical Leave Act of 1993 (FMLA), and all applicable amendments and regulations, eligible employees may be entitled to twelve (12) workweeks of unpaid, job-protected leave for certain family and medical reasons, or twenty-six (26) workweeks of leave to care for a covered military servicemember with a serious injury or illness. Eligible employees may use this form to request approval for that leave.

This form is only available when on-campus or when connected using VPN.

 

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Human Resources - Personal Information Support
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