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Form PL1

Application for Parental Leave

 
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Data Protection Act 1998 - we will only process your personal data in order to respond to your Parental Leave Request, which will be treated confidentially. In general it will be used for administrative, monitoring and statistical purposes.
 
For further information on parental leave please check the HR Web Pages.
 
 
 
 
 
Please indicate if you are a Newly Qualified Teacher
Please indicate if you are a Newly Qualified Teacher
 
 
Please use 'add' button to provide more than 1 Personnel Number
 
 
 
 
Date of Commencement with HCC *
Date of Commencement with HCC
 
Date of continuous local government service *
Date of continuous local government service
 
Is the Parental Leave for *
Is the Parental Leave for
 
Expected week of childbirth: *
Expected week of childbirth:
Actual date of birth
Actual date of birth
Expected week of placement *
Expected week of placement
Actual date of placement
Actual date of placement
 
A photocopy of the Mat B1 Certificate has been sent to Pay & Contract Support Services (PCSS)
A photocopy of the Mat B1 Certificate has been sent to Pay & Contract Support Services (PCSS)
 
A photocopy of the Matching Certificate has been sent to Pay & Contract Support Services (PCSS)
A photocopy of the Matching Certificate has been sent to Pay & Contract Support Services (PCSS)
 
Date Parental Leave to start
Date Parental Leave to start
Date parental leave to end
Date parental leave to end
Parental leave should not exceed 4 weeks.
 
 
I confirm that the above information is correct and that I understand and accept the conditions of the Parental Leave Scheme.
Please tick box *
 
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