1. SICK LEAVE BANK

2. 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.

3. 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

4. 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.

5. 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 * (256) * FAX: (256)

6. 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.

7. 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.

8. 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.

9. 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.

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

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

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