This form is an Employment Application. The form provides that applications are considered without regard to race, color, religion, or veteran status.
Employee Request Form For Fmla Leave In California
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If you do not have access to email to ask questions or to submit the form, please call or for assistance. This is a sample form for employees to request time off under the Family and Medical Leave Act.The employer should ask the employee to submit a written request for leave to begin the process. Your employer may require you to complete a request for CFMLA leave and medical certification. Use this form when an employee requests leave due to a qualifying exigency relating to a family member's military service.