Form L-8 - Request For Leave Of Absence To Teach In A Charter School printable pdf download

REV 7/13

L-8

METROPOLITAN NASHVILLE PUBLIC SCHOOLS

REQUEST FOR LEAVE OF ABSENCE

TO TEACH IN A CHARTER SCHOOL

The purpose of this type of leave is to allow the employee to retain accumulated leave and continuity of service. However, it should be noted

that the District can grant leaves only for specified periods of time. Employees may be granted leave to teach in a Charter School for up to one

year. Only tenured teachers qualify for this type of leave.

THIS COMPLETED FORM L-8 MUST BE SUBMITTED TO THE OFFICE OF EMPLOYEE BENEFITS AND APPROVED BEFORE THE LEAVE IS TAKEN.

Please answer all questions as completely as possible as inadequate information can delay processing.

SECTION I – (TO BE COMPLETED BY EMPLOYEE)

(Please Print)

Name _________________________________________ Employee # ______________Phone _________________

Address _______________________________________________________________________________________

(Street)

(City/ST)

(Zip)

School/Location ___________________________________________________ Title _________________________

Date Requesting to Begin Leave _________________________ Return Date _______________________

Charter School: _________________________________________________________________________________

Hire Date: _____________________________________________________________________________________

Employee Signature: ____________________________________________________Date ____________________

SECTION II (TO BE COMPLETED BY THE PRINCIPAL/DEPARTMENT SUPERVISOR)

I Acknowledge the Following Leave Request: From _______________To ____________

Comments: _____________________________________________________________________________________

Principal/Supervisor ___________________________________Title __________________________Date _________

Signature

SECTION III – (TO BE COMPLETED BY HUMAN CAPITAL)

APPROVAL STATUS:

( ) Leave is Approved

( ) Leave is NOT Approved

LEAVE DATES APPROVED From: ______/_______/_______ To: _______/_______/_______

Comments: _____________________________________________________________________________________

Approval Signature __________________________________________________ Date ________________________

EMPLOYEES MUST NOTIFY EMPLOYEE BENEFITS IN WRITING OF THEIR AVAILABILITY TO RETURN TO ACTIVE SERVICE

TWO WEEKS IN ADVANCE OF THEIR RETURN DATE

PLEASE RETURN FORM TO METROPOLITAN NASHVILLE PUBLIC SCHOOLS EMPLOYEE BENEFITS

2601 BRANSFORD AVE  NASHVILLE TN 37204  FAX 615/214-8665

QUESTIONS CALL 615/259-8410 or 259-8641

Form L-8 - Request For Leave Of Absence To Teach In A Charter School