Fillable Maternity/parental Leave Request Form printable pdf download

Maternity/parental Leave Request Form

Download a blank fillable Maternity/parental Leave Request Form in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Maternity/parental Leave Request Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

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Office of the

MATERNITY/PARENTAL

Provost and

Print Form

Reset Form

LEAVE REQUEST FORM

Vice-President (Academic)

Applicant Information

Name:

Position No:

Employee ID:

(optional)

Rank:

Category :

Tenured

Preliminary

Term

Current Appointment Information

Academic Unit:

Faculty:

FTE (eg .5)

(Home unit)

Maternity/Parental Leave

Doctor's certificate attached

Maternity Leave

Parental Leave

Start date:

End date:

Anticipated leave dates:

Please note: For maternity and parental leave, the signatures below represent acknowledgement and not approval. Final

confirmation will be issued directly by Human Resources before the start of leave.

Are you currently receiving an external grant administered by Carleton University Research Office?

Yes

Requested by

Applicant (print name)

(signature)

(date)

Recommended by:

Chair/Director/Dept Head (print name)

(signature)

(date)

Recommended by:

Librarians only

Associate University Librarian (print name)

(signature)

(date)

Recommended by:

Dean/University Librarian (print name)

(signature)

(date)

PLEASE SUBMIT TO THE PROVOST AND VICE-PRESIDENT (ACADEMIC) FOR ACTION

For more information, please consult Article 20 of the collective agreement between Carleton University and the Carleton University

Academic Staff Association (CUASA). Should there be any discrepancies between the collective agreement and this form, the

collective agreement is considered the final authority. For any questions, please contact your departmental administrator and/or

Dean's office.

The personal information requested on this form is collected in accordance with Sections 38(2) and 41(1) of the Freedom of Information and Protection of

Privacy Act (FIPPA), R.S.O. 1990, c.F.31 as amended. The information provided will not be used for any purposes other than those stated upon this form unless the

applicant provides express written consent. Should you have any questions concerning your personal information, please contact the Executive Assistant,

OPVAC, FIPPA Representative, (613)520-3884. Carleton University is fully compliant with FIPPA and endeavours at all times to treat your personal information in

accordance with this law.

OPVAC, August 2016: GREEN

VP (Research and International)

carleton.ca/provost

For maternal/parental leave only-Include Certificate