Intranet Maternity leave app teacher tcm2 38633

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					APPLICATION FOR STAFF TO COMMENCE MATERNITY LEAVE

This request must be made at least 28 days before maternity leave is to start.

Scheme A            Women with less than one year’s continuous local
                    government service

I wish to apply for maternity leave to commence on ........................................

My expected week of childbirth is .....................................................................

I attach confirmation of the date my baby is due



Scheme B           Women with at least one year’s continuous local government
                   service

I wish to apply for maternity leave to commence on ........................................

My expected week of childbirth is ...............................................................................

I attach confirmation of the date my baby is due
At the time of making this application:
 I intend to return to work at the end of my maternity leave
 I understand that this is only asked in order to calculate
   Occupational Maternity Pay
 I would like my occupational maternity pay to be paid as follows:
   - 12 weeks at half pay
   - 20 weeks at 3/10 of full pay
   - 6 weeks full pay when I return from maternity leave
 If I do not return to local authority employment for 3 months at the
   end of my period of maternity leave I will refund to the Council the
   half pay I have received



Name .......................................................................Payroll No ............................

School ............................................................……………………………………….

Home Address .....................................................................................................

..............................................................................Post Code ..............................

Signed .......................................................................Date...................................

Headteachers signature ………………………Telephone number ……………….

If you wish to change the start date of your maternity leave you must advise your headteacher at
least 28 days in advance, unless this is not reasonably practicable.

				
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