Wku Request For Leave And Notice Of Eligibility And Rights & Responsibilities (Family And Medical Leave Act)

Download a blank fillable Wku Request For Leave And Notice Of Eligibility And Rights & Responsibilities (Family And Medical Leave Act) 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 Wku Request For Leave And Notice Of Eligibility And Rights & Responsibilities (Family And Medical Leave Act) with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

Human Resources
Wetherby Administration Building
1906 College Heights Blvd. #11003
Bowling Green, KY 42101
Attn: Denise Cornelius
Phone: 270.745.5345
Fax: 270.745.5582
Request for Leave and
Notice of Eligibility and
Rights & Responsibilities
(Family and Medical Leave Act)
_____________________________________________________________________________________________
_____________________________________________________________________________________________
To be eligible for FMLA an employee must have been employed by the University for at least 12 months,
have worked for the university at least 1,250 hours during the last 12 months immediately preceding the
leave.
Part B provides you with information regarding your rights and responsibilities for taking FMLA leave.
Part A – NOTICE OF ELIGIBILITY
Employee Name: ______________________________________________________________________
First
Middle
Last
Home Address: ________________________________________________________________________
________________________________________________________________________
City
State
Zip
Telephone:
(
) ____________________________ (
) __________________________________
Home
Other
Employee identification number: ___________________
Department you are employed in: _________________________________________________________
Job Title: _____________________________________________________________________________
Date leave is to start: __________________________ Intermittent Leave: ____Yes____No
Date to return to work:
___________________________________________________________
Reason for the leave request:
____
The birth of a child;
____
Placement of a child with you for adoption or foster care;
____
Your own serious health condition;
Page 1 of 3

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Request For Ds-2019 Certificate Of Eligibility For Exchange Visitor Status Request For Ds-2019 Certificate Of Eligibility For Exchange Visitor Status Legal
Form Rev-516 Ex - Request For Waiver Or Notice Of Transfer - Pennsylvania Departament Of Revenue Form Rev-516 Ex - Request For Waiver Or Notice Of Transfer - Pennsylvania Departament Of Revenue Legal
Form Rev-516 Ex - Request For Waiver Or Notice Of Transfer Form Rev-516 Ex - Request For Waiver Or Notice Of Transfer Financial
Form Rev-516 - Pennsylvania Request For Waiver Or Notice Of Transfer Form Rev-516 - Pennsylvania Request For Waiver Or Notice Of Transfer Financial
Form Rev-516 - Request For Waiver Or Notice Of Transfer Form Rev-516 - Request For Waiver Or Notice Of Transfer Financial
Notice Of Eligibility And Rights & Responsibilities - Family And Medical Leave Act (fmla) & California Family Rights Act (cfra) Notice Of Eligibility And Rights & Responsibilities - Family And Medical Leave Act (fmla) & California Family Rights Act (cfra) Business
Notice Of Eligibility And Rights & Responsibilities - Family And Medical Leave Act (fmla) & California Family Rights Act (cfra) Notice Of Eligibility And Rights & Responsibilities - Family And Medical Leave Act (fmla) & California Family Rights Act (cfra) Business
Notice Of Eligibility And Rights & Responsibilities (family And Medical Leave Act) - Colorado State University Notice Of Eligibility And Rights & Responsibilities (family And Medical Leave Act) - Colorado State University Business
Request For Leave Under The Family And Medical Leave Act (fmla) (for Administrative And Pedagogical Staff) - Nyc Department Of Education Request For Leave Under The Family And Medical Leave Act (fmla) (for Administrative And Pedagogical Staff) - Nyc Department Of Education Business
Request For Leave Under The Family And Medical Leave Act Of 1993 (fmla) - Massachusetts Bay Transportation Authority Request For Leave Under The Family And Medical Leave Act Of 1993 (fmla) - Massachusetts Bay Transportation Authority Business

Related Categories

Parent category: Business
Download
Go
Page of 3