Family Medical Leave Request Form
Ohio Hi-Point Career Center staff members have a right under the Family Medical Leave Act (FMLA) to 12 weeks of unpaid leave per school year (July 1 – June 30) for the reasons listed below. To initiate a request for FMLA, complete this form and submit it to the Superintendent’s office at least 30 days prior to your need for leave, unless leave is unforeseen in which case submit the form as soon as practical. The purpose of this form is to gather information about your request and determine eligibility.