Get California State University Fmla/cfra Notice And Request Form 2011-2025

This guide provides clear, step-by-step instructions on how to effectively complete the California State University FMLA/CFRA Notice And Request Form online. Whether you are a staff member or faculty, this resource is designed to assist you through the process with ease.

Follow the steps to complete your FMLA/CFRA notice and request form online.

1. Click ‘Get Form’ button to retrieve the form and open it in the appropriate application.
2. Begin by entering the notification date in the designated field. This is the date on which you are submitting the request.
3. Select your employment status by checking either 'Staff' or 'Faculty' as applicable.
4. Indicate if you are requesting FMLA or declining FMLA by selecting the appropriate option.
5. Specify the FMLA/CFRA effective date by filling in the corresponding date field.
6. In the 'Employee Leave Request' section, choose the reason for your leave and list the date of action or due date, ensuring that the information matches your circumstances.
7. Provide your last day worked or the start date of the FMLA leave, followed by the expected return to work or end date of the FMLA leave.
8. Select the type of leave you are requesting: Full-Time, Partial Leave, or Intermittent. Make your choice based on your needs.
9. If your FMLA leave is unpaid, indicate whether you wish to continue your insurance plans by circling 'Yes' or 'No' for medical, dental, and vision.
10. Fill out your personal details, including your name, CSUF ID number, home address, home or cell phone number, and the department you work in.
11. Sign and date the form to validate your request.
12. Once you have filled out all the necessary fields, save your changes, then download, print, or share the document as required.

Complete your California State University FMLA/CFRA Notice And Request Form online today.