Application for Adoption Leave Form

Please use this online form to notify the HR Employment Support Services Team of your application for adoption leave.

Your Details

Name*
Email*
School/Department*
Payroll Number*
Home Address*

Country*

Postcode*
 

Address*


Town*

Details of Adoption Leave Requested

Please accept this notification as my application for adoption leave.

I wish to begin my adoption leave on:*
The matching date was:*
File Upload - Matching certificate or letter from the adoption agency*

Valid upload file types: .doc .docx .pdf
The total size of all files on the form cannot be more than 10 MB
The anticipated date of adoption placement is:*
I agree to send to the Human Resources Department (hr@nottingham.ac.uk), a copy of the papers confirming that the adoption placement took place, as soon as I have obtained this document.
 
If eligible for 52 weeks’ adoption leave, I understand that if I choose to return earlier than the first working day after 52 weeks’ adoption leave I have to give at least 8 weeks’ written notice of my intention to return to work to the HR Department.
 
If eligible for less than 52 weeks’ adoption leave I will need to give 8 weeks’ written notice of my intention to return to work to the HR Department.
 
I understand that I should take annual leave in the standard annual leave year, and I will book this annual leave with my line manager in the usual manner.
 
I understand that should I wish to resign from my employment with the University during my adoption leave, I must give the University written notice in accordance with my contract of employment.
 
I understand that if I receive payment under the Enhanced University Adoption Scheme (other than Statutory Adoption Pay) it is subject to me returning to work for a minimum of 3 months following adoption leave.
 
If I am unable to fulfil this requirement I understand I will be required to repay any entitlements received in excess of the statutory pay.
 

Evidence of my parental responsibility

File Upload - Papers confirming my child(ren)s adoption or letter from the adoption agency confirming anticipated date of the adoption placement*

Valid upload file types: .doc .docx .pdf
The total size of all files on the form cannot be more than 10 MB
File Upload

Valid upload file types: .doc .docx .pdf
The total size of all files on the form cannot be more than 10 MB

Pension

Please select as appropriate:*




Note: for members of the NHS pension scheme there is a requirement to make pension contributions during unpaid adoption leave. Arrangements will be made to repay the full employee contribution for the unpaid adoption leave period on return to work.
 
I would like (subject to scheme rules allowing this) on my return to work to repay the employee pension contribution for any unpaid adoption leave so that my membership is continuous.
Please select:

Car Benefit Scheme

Please select:*

Note: If I am a member of the scheme, I understand that the University will send a copy of my Matb1 form (or equivalent) to Tusker to enable a claim through the protection insurance.

Annual Leave Pension Scheme

Please Select:

Line Manager Approval

I can confirm that I have discussed this application for adoption leave with my line manager and he/she has agreed the dates stated above?*

Line Manager's Name*
Comments*
Verification*