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Request for Leave

Request for Leave

This form is to be used by employees of Lamar CISD to apply for an extended leave of absence (i.e., FMLA, TDL). After completing the form and clicking the "submit" button at the bottom of the page, your request will be emailed to the LCISD Employee Benefits Office. Please allow two working days for your request to be processed. If you have any problems with the form or questions about your leave request, please contact Cheryl Koteras at 832.223.0313.

This form will be transmitted securely to protect sensitive data.

- Required Field

 Continuous
 Intermittent leave as needed
  Your own serious health condition
  Birth of a child or placement of a child with you for adoption or foster care
  You are needed to care for your:
  Spouse
  Parent
  Child under age 18
  Child 18 years or older and incapable of self-care because of a mental or physical disability
  A qualifying exigency arising out of the fact that your family member is on covered active duty or has been notified of an impending call or order to covered active duty status. Your family member on covered active duty is your:
  Spouse
  Parent
  Child of any age
  You are needed to care for your family member who is a covered servicemember with a serious injury or illness. You are the servicemember's:
  Spouse
  Parent
  Child
  Next of kin