Apply for Leave of Absence
Eligible employees may apply for a leave of absence in accordance with the University policy and type of leave.
FMLA Leave of Absence
Eligible employees may request a FMLA Leave of Absence for medical, family or military family reasons. To request an FMLA leave, contact our FMLA Administrator FMLASource®. FMLASource® is an easy and convenient way to request, track and manage family and medical leave. You can access your FMLA information:
24 hours a day
7 days per week
Monday – Friday
8:30 am – 8:00 pm, EST
To apply for FMLA leave, follow these steps:
- Follow the normal reporting procedures by notifying your Supervisor (or designed representative) anytime you are absence from work (including FMLA leave absence)
- To submit your leave request, contact FMLASource:
- Call FMLASource at 1-877-462-FMLA (1-877-462-3652), or
- Log onto www.FMLASource.com (you will need your Access code = your Banner ID) and follow the instructions
When you login at www.FMLASource.com, you can:
- Request a FMLA leave
- Download medical certification and related forms
- Check the status of a FMLA leave
- Keep track of FMLA leave
- Learn about federal FMLA regulations
For your reference, link to the following information:
- Employee Handbook
- Family and Medical Leave Act: http://www.dol.gov/whd/fmla/
- Your Rights and Responsibilities under the FMLA
- DOL Employee Guide to the FMLA
- FMLASourceSM Poster
- FMLASourceSM IVR Guide (Telephone Access Instructions)
For more information about your FMLA rights and responsibilities, please contact the Office of Human Resources at 248.204.2150 or email firstname.lastname@example.org
Other [Non-FMLA] Leave of Absence
Eligible employees may wish to take time off for (Non-FMLA) reasons that includes:
- Jury Duty
- Time off to Vote
- Witness Duty
- Medical Leave not covered under FMLA
To apply for Other [non-FMLA leave] Leave of Absence, follow these steps:
- Follow the normal reporting procedures by notifying your Supervisor (or designed representative) anytime you are absence from work
- To submit your leave request
- For military, personal or medical leave not covered under FMLA, complete the Request for Non-FMLA Leave of Absence Form #3112
- For a medical leave not covered under FMLA, also submit the Non-FMLA Medical Certification Form #3110.
- For information regarding leave time related to bereavement, jury duty, time off to vote or witness duty, contact the Office of Human Resources at email@example.com.
Leaves of Absence Applicable to Faculty Only
Faculty may be granted a leave of absence for professional purposes or for personal reasons that includes:
- Sabbatical Leave
- Leaves of Absence Without Pay
For information on how to apply for a Sabbatical Leave or Leaves of Absence Without Pay, contact the Department Chairperson and Office of the Dean.
Questions? Email firstname.lastname@example.org
Lawrence Tech in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend or terminate them.
Every effort has been made to ensure the accuracy of the benefits information in this site. However, if any provision on the benefits plans is unclear or ambiguous, the Office of Human Resources reserves the right to interpret the plan and resolve the problem. If any inconsistency exists between this site and the written plans or contracts, the actual provisions of each benefit plan will govern. Lawrence Tech in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents.