Medical Leave / Illness Leave
A medical absence of more than five (5) days needs to be verified with a written statement from the
attending medical doctor, and the completion of the Leave of Absence and FMLA forms.
Family Illness
Relationship to employee
Eligible leave is available for illness of a child, parent, and spouse/registered domestic partner.
Personal Necessity
Reason
In accordance with the Education Code and the Collective Bargaining Agreement, an employee may use
accumulated sick leave in cases of personal necessity for a significant event, personal to the employee,
for which leave of absence is not authorized, which under the circumstances the employee cannot
reasonably be expected to disregard and which requires the immediate attention of the employee
during the assigned hours of service. The specific significant event shall be given in writing to the
administrator in charge. I hereby certify that my absence is necessary because of the reason I have
stated above. Prior notice is required as referenced in the Collective Bargaining Agreement.
Compelling Personal Need
None of these days may be used prior to any holiday period or on the day immediately following any
holiday period. Exception for Classified employees defined in the Collective Bargaining Agreement. Prior
notice is required as referenced in the Collective Bargaining Agreement.
Vacation
Must be submitted to supervisor at least two (2) weeks prior to the anticipated vacation.
Bereavement
Relationship to employee
Eligible leave is
defined in the Collective Bargaining Agreement.
Personal (Unpaid)
Reason
All unpaid personal leave must be submitted to the Personnel Department for approval. Five (5) days or
longer must be requested on the Leave of Absence form. *Unpaid time could affect your service credit if
you are a CalSTRS or CalPERS member.
Other
Reason
East Whittier City School District
TIME OFF REQUEST
Name
Site/Department
I am requesting to be absent from work for the following days and hours:
Total Day(s) Date(s)
to
Total Hour(s)
Hours to be absent
am / pm
to
am / pm
For the following reason(s):
Signature of Employee
Date
Signature of Supervisor
Date
Approved
Denied
Yes
No