Online Leaves Request Application

This online application has made available for eligible City Schools employees to make requests for leaves.

General Information

Please enter your employee identification number (a 5-digit or less #) below.

Phone

If you work at multiple locations, please list your primary work location.

What is your preferred method for communication to receive a status of your application?*

Leave Type

In this section you will select the type of leave you would like to request in this application.

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You are requesting FMLA; please indicate the type. Please refer to your doctors completed medical certification for your leave type.*

An eligible employee who has complied with the Family and Medical Leave Act regulations and verification requirements must be granted FMLA (see Benefits Handbook), up to 12 weeks/60 days within a 12 month period. Please keep in mind that this request type is subject to changed following recommendation of your doctor.

Military Leave

Maryland State Board Bylaws provide that all public school system employees who are members of the organized militia or the Army, Navy, Air or Marine Reserve, shall be entitled to a leave of absence from their respective duties, without loss of pay, time or efficiency rating, on all days during which they shall be engaged in field or coast defense or other training ordered or authorized under the provisions of Article 65, Annotated Code of Maryland, or under any law of the United States, during such time as they are on inactive duty, not to exceed 15 days annually.

Educational Leave (PSRP)

Any Paraprofessional who is engaged in an educational program and who may need a leave of absence for student teaching or other reasons to complete requirements for graduation shall be granted such leave with pay, and shall be assured a reassignment to his former position or one comparable at the end of such leave. Paraprofessionals on educational leave for the purpose of student teaching or matriculating in an institution of higher education shall have health care benefits continued by the Board.

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Sabbatical Leave (BTU & PSASA)

BTU AGREEMENT – Employee MUST have completed seven (7) years of consecutive service prior to commencement of leave. All applications are to be submitted by December 15th of the year preceding the commencement of the leave. By signing the application, the employee also agrees to return to the System for at least one (1) year of service following expiration of the leave. As an option to this service requirement, the employee may elect to return the salary received during the period of leave. PSASA AGREEMENT – Employee must have completed ten (10) years of consecutive service prior to the commencement of leave. All applications are to be submitted by April 1st (for leaves to begin September 1st) or November 1st (for leaves to begin February 1st). By signing the application, the employee also agrees to return to the System for at least three (3) years of service following expiration of the leave. As an option to this service requirement, the employee may elect to return the salary received during the period of leave. COMPENSATION & BENEFITS - The employee receives fifty (50) percent of his or her annual salary while on leave. The employee’s benefit status will remain active. Premium deductions for the various benefits will be deducted from the employee’s bi-weekly paycheck (if applicable). If the employee’s bi-weekly earnings do not cover the cost of the benefits, an invoice will be sent to the employee (by the Department of Fiscal Management) for his/her portion of the benefits premium that would normally be deducted from a paycheck.

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Unpaid Childcare and Unpaid Personal Leave

An employee, at their request, may be granted a leave of absence without pay for the purpose of child-bearing or child rearing for such period of time they specify, but not to exceed ONE (1) year. An extension may be granted, but not beyond the beginning of the school year following the child’s third birthday.


Please provide the following document(s) to support your request.

a) "Medical Certifications for Employees Own Serious Health Condition" form completed by your physician You can download this form from City Schools here: https://www.baltimorecityschools.org/leaves

a) "Medical Certification for Eligible Family Members" form completed by your physician You can download this form from City Schools here: https://www.baltimorecityschools.org/leaves

a) Copy of your military orders

a) Official Letter of Acceptance from the College or University Registrar’s office b) Proof of enrollment from Registrar’s office Per semester class load hours and a list of courses to be completed Please Note: At the end of each semester, official documentation from Registrars’ office denoting course(s) completion MUST be submitted within 14 days of semesters ending to the Office of Leaves Management, failure to do so will terminate your Sabbatical Leave Status. Area of study MUST be directly related to your employment status.

a) Official Letter of Acceptance from the College or University Registrar’s office b) Proof of enrollment from Registrar’s office Per semester class load hours and a list of courses to be completed Please Note: At the end of each semester, official documentation from Registrars’ office denoting course(s) completion MUST be submitted within 14 days of semesters ending to the Office of Leaves Management, failure to do so will terminate your Sabbatical Leave Status. Area of study MUST be directly related to your employment status. ONLY IF YOU ARE APPLYING FOR STUDY & TRAVEL... c) Detailed Itinerary (and provide DETAILED plans for disseminating information to students and/or staff upon your return) [Please note: Travel must be directly related to your employment status.]

a) Copy of your child's birth certificate

a) Any supporting documentation that you believe is helpful to support your request

Drag and drop files here or

Important information for applicants applying for FMLA

PLEASE READ If currently Enrolled in Baltimore City Public School’s Health Care Plans: Paid Status: Healthcare Premiums will be deducted from your paycheck as normal Unpaid Status: If your status is unpaid or you lapse into unpaid status you must continue to pay your EMPLOYEE contributions. Finance will invoice you your premium amounts. Three unpaid EMPLOYEE contributions will result in termination of your health care insurance coverage. If your status is unpaid or you lapse into an unpaid status and your Employee contributions are not paid for more than three (3) pay periods, you have a right to COBRA continuation coverage. A COBRA election form will be mailed to your address on file by our Third Party Administrator. COBRA is a temporary extension of coverage pursuant to the Consolidated Omnibus Reconciliation Act of 1985. COBRA continuation coverage can become available to you and to other covered members under your plan when you would otherwise lose your group health care coverage.

Important information for applicants applying for leave request that is NOT related to FMLA

PLEASE READ If Currently Enrolled in Baltimore City Public School’s Health Care Plans: Unpaid Status you will have an opportunity to re-enroll your benefits during the first 30 days of your return to active duty. Your status is unpaid and your benefits will terminate at the end of the month in which your leave began. You have a right to COBRA continuation coverage. A COBRA election form will be mailed to your address on file by our Third-Party Administrator. COBRA is a temporary extension of coverage pursuant to the Consolidated Omnibus Reconciliation Act of 1985. COBRA continuation coverage can become available to you and to other covered members under your plan when you would otherwise lose your group health care coverage. Leave IS NOT authorized unless approved by the Department of Human Capital. Failure to received prior approval may result in appropriate disciplinary action. Once approved, you will be placed on an approved leave of absence and transferred off of your locations run and placed on 2026. The 2026 organization is a payroll organization for employees currently on a long term leave of absence. 30 days prior to the end of your leave approval date, you must contact Leaves Management by email or in writing to request your placement in an active assignment. Leaves Management will forward your request to the appropriate department that will handle your placement to an active assignment.


FMLA Acknowledgement

Any employee who knowingly and/or purposefully provides false information in an attempt to gain approval of FMLA may be subject to disciplinary action, up to and including termination. Any employee who knowingly abuses the use of approved FMLA leave for the purpose of monetary gain, recreational pleasures, or any such actions that are deemed contrary to the basic intent of the FMLA may be subject to disciplinary action, up to and including termination. Statement for acknowledgement: "I acknowledge that I have read, and do hereby accept the terms and conditions contained in this online request for the use of FMLA and the Electronic Statement."

Non-FMLA Acknowledgement

Any employee who knowingly and/or purposefully provides false information in an attempt to gain approval of any leave request may be subject to disciplinary action, up to and including termination. Any employee who knowingly abuses the use of approved leave for the purpose of monetary gain, recreational pleasures, or any such actions that are deemed contrary to the basic intent may be subject to disciplinary action, up to and including termination. Statement for acknowledgement: "I acknowledge that I have read, and do hereby accept the terms and conditions contained in this online request for the use of requesting leave and the Electronic Statement."