ࡱ> :<9M bjbjd&d& .LGiLGi ^^^^^rrrrr$>^>^^SWWW ^^WWWji0,o (o o ^$W>>/(o X $: SURROGACY LEAVE APPLICATION FORM SL1 TO BE COMPLETED BY THE EMPLOYEE, APPROVED BY THE DEPARTMENT HEAD AND SUBMITTED TO THE DEPARTMENT OF HUMAN RESOURCES. EMPLOYEE NAME: ___________________ Staff No.: ________ DEPARTMENT: ______________________ HEAD OF DEPT.:_________________ Draft Procedures Surrogacy Leave The employee informs the Line Manager in writing of the pending Surrogacy leave as soon as is practicable, but no later than four(4 ) weeks before the due date of the child. A medical certificate is required from a registered medical practitioner in Ireland or abroad to confirm the due date of the baby and the surrogacy arrangement . For practical reasons, it is desirable that employees provide as much notice as possible so that appropriate arrangements can be made, vis-- vis, workload distribution or replacement. The employee applies to the Department of Human Resources for surrogacy leave using an Application for Surrogacy Leave Form SLI. A Birth Certificate must be submitted to the Department of Human Resources as soon as is reasonably practicable, but no later than four weeks after the Date of Birth of the baby. The Department of Human Resources will validate the leave claim and communicate directly with the employee, following receipt of the SL1. If the employee wishes to avail of the sixteen (16) weeks extended leave, s/he must do so by writing to the Department of Human Resources and the Head of Department at least four (4) weeks prior to the expected date of return. The staff member must provide the Department of Human Resources with written notification of his/her intention to return to work, and the expected date of return, no later than four (4) weeks before the expected date of return. If the employee wants to take annual leave at the end of the twenty six (26) weeks maternity leave or extended sixteen (16) weeks unpaid leave, then an Annual Leave Form must be completed and approved by the Head of Department at least four weeks before the expected return date and forwarded to Human Resources prior to the annual leave commencing. CONTACT: Ms Kathy O'Connell, Department of Human Resources and Organisational Development, Ground Floor, Block E, Food Science Building, ҹ޸þ College Cork. Tel. 4902674. E-mail:HYPERLINK "/en/hr/policies/leave/adoptive/k.oconnell@ucc.ie%20"k.oconnell@ucc.ie Commencement Date of Leave : __________Duration of Leave :________________ Additional Leave: ______________________ Birth Due Date:_________________ Please attach evidence of your entitlement to Surrogacy Leave, (A Medical Certificate to confirm due date of baby by surrogacy by a registered medical practitioner in Ireland or abroad.) Signed : ______________________________ Date : ____________________________ Note: The form must be presented to your Head of Department/Manager at least four weeks prior to the proposed date of commencement of leave. 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