FMLA Request for Leave Form
Sample FMLA Request form to be used if your school is required to offer FMLA (Family and Medical Leave Act) leave to your employees. If you are working with an employee leasing or payroll company they may have a form you may be required to use, however, if they do not, this sample document could be modified to be used at your school.
Downloads:
- FMLA Request For Leave.pdf (PDF •62.3KB File Size)
- FMLA Request For Leave Form Completable.pdf (PDF •686.2KB File Size)
- FMLA Request For Leave.docx (Word Document •47.6KB File Size)