SICK LEAVE BANK

SICK LEAVE BANK PARTICIPATION Participation, only costs you 3 sick leave days If you are a new employee and have not accrued any sick leave days, payroll will deduct them as you earn them. To join, complete the participation form found on the intranet. IMPORTANT! You may only join during Open Enrollment from July 1-Aug. 31.

PARTICIPATION FORM Madison City Schools Authorization for Sick Leave Bank Participation Name: ____________________________________________________ Last First Middle School: ____________________________________________________ Position: ____________________________________________________ ______ I wish to become a member of the Sick Leave Bank and hereby authorize that three (3) days from my personal sick leave account be placed in the Bank. ______ I wish to become a member of the Sick Leave Bank, but do not have the three (3) days in my account to become a member. I hereby authorize the next three days earned to be placed in the Bank. _______________________________________________ _________________________________ Signature Date ------------------------------------------------------------------------------------------------------------------------------- (for office use only) APPROVAL: _____________________________ _______________________ Sick Leave Bank Chairperson Date

SICK LEAVE BANK You may resign from the Sick Leave Bank at any time You must complete the resignation from and send to Daphne Jah, West Madison Elementary School.

RESIGNATION FROM SICK LEAVE BANK Madison City Schools Notice of Resignation from the Sick Leave Bank Employee ID#___________ Date_________________ Name _________________________________________________ Address________________________________________________________ Position_____________________ City__________________State________________Zip Code______________ Work Site ___________________ I hereby terminate my participation in the Madison City Schools Sick Leave Bank and request that days on deposit in the SLB be returned to my personal sick leave account. Signature_____________________________________________________________ Date____________________________ Please note: 1) One (1) copy of this form must be sent to the chairperson of the Sick Leave Bank Committee, Madison City Schools. 2) One (1) copy of this form must be sent to the Madison City Schools Payroll Office. 3) One (1) copy should be retained for the employee's records. _____________________________________________________________________________________________ Madison City Schools * 211 Celtic Drive * Madison, AL 35758 * (256) 464-8370 * FAX: (256) 464-8291

Borrowing days from the Sick Leave Bank You may borrow up to 15 days from the sick leave bank. Complete the Application to Borrow Sick Leave Days and send to Daphne Jah, West Madison Elementary School.

Catastrophic Leave You may apply for Catastrophic Leave after you have exhausted all forms of leave; sick leave, personal leave, vacation leave and have previously borrowed 15 days from the Sick Leave Bank.

Catastrophic Leave When you apply for catastrophic leave you must complete the form and return the form and doctor’s documentation to Dr. Jah at West Madison.

Catastrophic Leave When you are approved for Catastrophic Leave employees from Madison City and other school systems who are members of the Sick Leave Bank may donate days to you.

IMPORTANT!!!! You must be a member of the Sick Leave Bank to donate days to an individual!!!!

All Forms are Attached Once you have completed the form, make sure you have the appropriate documentation then ecopy/email them to me djah or send them in the interoffice mail to Daphne Jah, West Madison Elementary School.

I encourage you to join during open enrollment! Open Enrollment is from July 1-August 31!