Roseville City School District

FMLA
Family Medical Leave Act

Pod

If you will miss work for an extended period due to either your own serious health condition or the serious health condition of an immediate family member, please print out the appropriate form below:

Please contact the Substitute Services Coordinator, Melinda Pon (916) 771-1600 ext. 50154 to have your absence entered into Absence Managment.

Completed forms should be submitted to the Personnel Department.