SPL11 - Request for SPL Form

Please use this online form to notify HR of your application as a parent for Shared Parental Leave (SPL).

Your Details

Full Name*
Email Address*
Payroll Number*
School/Department*
Date of maternity leave ending:*
I refer to the Notice of Entitlement and intention to take leave I submitted dated:*

I am writing to let you know that I would like to request a period of Shared Parental Leave (SPL).

Start date (must be at least 8 weeks after the date of this notification):*
End date (SPL must be taken before your child's first birthday)*
I would like to take further period(s) of SPL leave from/to:*

You may ask for more than one period of leave in a single request for leave notice. However, we are not obliged to agree to requests for discontinuous leave.

For more details about requesting leave, please see our Shared Parental Leave Policy.

Pension

Please select as appropriate:*




Note: For members of the NHS Pension Scheme, there is a requirement to make pension contributions during unpaid shared parental leave. Arrangements will be made to repay the full employee contribution for the unpaid shared parental 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 shared parental leave so that my membership is continuous.

Please Select:

Line Manager Approval

Line Manager's Name*
I can confirm that I have discussed this application with my line manager and he/she has agreed the dates stated above?*

Date of Meeting*
Additional Comments*
Verification*