Gadsden Elementary School District #32

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Families First Act Leave Application Form

The Families First Coronavirus Response Act became effective on April 1, 2020 through December 31, 2020. Employees that would like to apply for this leave must complete this application form electronically or request a hard copy at agonzalez@gesd3.org. Employees that submit this application form will be notified by Human Resources if approved. Employees must submit the appropriate documentation regarding their leave request with this application if required. Please contact Human Resources with any further questions or concerns by emailing agonzalez@gesd32.org

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La Ley Familias Primero de Respuesta al CoronaVirus aplicara desde abril 1 hasta diciembre 31 del 2020. Empleados que deseen aplicar para esta ley deberan llenar esta solicitud electronica o pedir una copia a agonzalez@gesd32.org. Empleados que entregan esta solicitud seran notificados por recursos humanos de ser aprovada. Empleados deberan entregar la documentacion apropriada para su peticion con esta solicitud. Favor de contactar a recursos humananos para cualquier duda o pregunta al correo electronico agonzalez@gesd32.org

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Employee Information/Información de Empleado

Site/Escuela o Departamento*
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Please select the reason for your request. Employees must attach medical notes for request #1-5/Por favor seleccione la razon de su solicitud. Razones #1-5 requieren que adjunte justificante/carta medica.
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Upload doctor's letter / Adjunte Justificante-carta médica
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Please upload a statement that your daycare/babysitter is not available due to COVID-19 for non-school aged children only / Por favor adjunte un escrito especificando que cuidados infantiles/niñera no están disponible por motivos de COVID-19 para sus hijos que aún no tienen la edad para entrar a la escuela.
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Type of Leave Requesting*
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