NW Sick Bank - Request Form
Teachers who are requesting leave from the sick bank will fill out the sick back request form to start the approval process.  

Sick Leave Bank— After one (1) full year of employment any employee who has
exhausted his/her accumulated PTO leave days, may apply to a sick leave bank, for
use during an approved medical leave.

Teachers shall deposit one (1) accumulated
leave day to the bank if at the beginning of any school year the bank contains less
than six hundred (600) days. By a vote of the general membership once a year one
additional day per teacher may be added to the bank.

All PTO leave days accumulated by a teacher in excess of the 195 day maximum
shall be added to the bank.

There shall be a sick leave bank committee composed of two members of the
teaching staff and two members of the administration. The committee shall be
empowered to formulate the necessary rules and regulations for the operation of the
sick leave bank. The rules and regulations as compiled by the committee shall
become a part of this agreement by a letter of understanding.

Withdrawals may be requested from the bank by written application to the sick leave
committee by a teacher who has exhausted his/her own leave days. The committee
shall be empowered to approve or disapprove all such applications and to determine
the number of days allowable if approved.

Any employee receiving such an allowance from the bank will not be expected to
repay. A bargaining unit member shall be eligible, under the rules of the committee,
to draw from the bank for a maximum of 25 days in a school year.
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Email *
After submitting this form your request will be processed and you will be notified of a decision from the Sick Bank Committee.
Name *
Reason For Leave ( Please send all supporting documentation to Julie Lawless - julie.lawless@nwschools.com) *
Date to begin leave *
MM
/
DD
/
YYYY
Date to end leave *
MM
/
DD
/
YYYY
Date employees sick time will be exhausted *
MM
/
DD
/
YYYY
Dates for 3 day unpaid waiting period *
Number of sick days requesting *
A copy of your responses will be emailed to the address you provided.
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