Staff Change of Information Form
      Return completed form to Cheryl Chipps at the District Office  
 
 
 
  
  
FMLA/OFLA Leave Forms
 
Employees are required to give 30 day’s written notice in advance of leave to the Siuslaw School District Human Resource Specialist, unless the leave is taken for an emergency. The notice MUST include the anticipated start and end date (estimated, if necessary), reason for the requested leave and relation to ill family member (if applicable). The Human Resource Specialist will determine your eligibility and will contact you with further information within five business days.
 
When an employee is absent, or anticipates being absent, more than three consecutive calendar days for the following reasons: their own serious health condition, family medical need, parental, bereavement, or family military-related reason, the District requires that you follow the Siuslaw School District medical leave application process. The District is required by law to determine your eligibility for job-protected leave under the federal Family Medical Leave Act (FMLA) and the Oregon Family Leave Act (OFLA). Per District policy, you have the option to use certain available paid leave during the same time as your FMLA/OFLA Leave. 
  
 
 
 
 
 
 
 
 
 
 
Last Modified on March 10, 2017
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