SPL13 - Application for Parental Leave Form

Please use this online form to submit an application to HR for parental leave.

Your Details

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

In sending this form, I am asking you to please accept this as notification as my application for parental leave.

I wish to take parental leave from:*
I anticipate to end my parental leave on:*

Details of my child(ren)

The date of birth of my child(ren) is:*
The date of the adoption placement is due to begin on:*
The date I obtained legal responsibility for my child(ren) was:*

Evidence of my Parental Responsibility

Please upload evidence of your parental responsibility:

  • Birth certificate (on which the applicant is named as a parent)
  • Letter from the adoption agency confirming anticipated date of the adoption placement
  • Papers confirming my child(ren)s adoption
  • Maternity certificate (MAT B1)
  • Medical evidence confirming the expected date of childbirth (MAT B2)
  • Papers confirming my child(ren) receives disability living allowance
  • Papers confirming I have acquired legal parental responsibility under the Children Act 1989
  • Other - please specify below
File Upload*

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
Other - Please specify

Please note that if you have previously supplied this information to Human Resources whilst making an earlier application for parental leave, there is no need to send in the documentation again.

However, if you are making an application for a different child, please forward the relevant document(s).

Verification*