METROPOLITAN NASHVILLE PUBLIC SCHOOLS
REQUEST FOR EDUCATIONAL
LEAVE OF ABSENCE
The purpose of this leave is to allow the employee to retain benefits such as insurance, accumulated leave and continuity of service. However,
it should be noted that the District can grant leaves only for specified periods of time. Educational leaves are granted to employees up to one
(1) year. Five (5) years of service or more are required for educational leaves. Documentation or enrollment/registration is required for
Educational leaves as well as class schedule and proof of tuition payment. Full time employment is not allowed while on Educational Leave.
You will need to contact the Employee Benefits office (259-8644 or 259-8484) for information regarding your insurance and benefits.
NOTE: THERE IS NO PAY FOR EDUCATIONAL LEAVE.
THIS COMPLETED FORM L-2 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)
Name _________________________________________ Employee # ______________Phone _________________
School/Location ___________________________________________________ Title _________________________
Date Requesting to Begin Leave _________________________ Return Date _______________________
College or University: ___________________________________________________________________________
Course of Study: _______________________________________________________________________________
Employee Signature: ____________________________________________________Date ____________________
SECTION II (TO BE COMPLETED BY THE PRINCIPAL/DEPARTMENT SUPERVISOR)
I Acknowledge the Following Request for Educational Leave From __________________To ___________________
Principal/Supervisor ___________________________________Title __________________________Date _________
SECTION III – (TO BE COMPLETED BY HUMAN CAPITAL)
( ) Leave is Approved
( ) Leave is NOT Approved
LEAVE DATES APPROVED From: ______/_______/_______ To: _______/_______/_______
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