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Paid Family Leave Form

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Student Details


Leave Period

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Declarations

I confirm that I agree to repay any paid family leave stipend provided to me should I fail to return to my studies for a minimum of 3 months, or until I submit my thesis, once the period of paid family leave has finished. (required)
I understand that an application for paid family leave must be submitted at least two weeks in advance of when the leave is due to be taken. Paid family leave cannot be backdated (excluding exceptional circumstance i.e. premature birth of the child, that make this impossible). (required)
I have submitted a temporary withdrawal or authorised absence request with the same dates as this claim for paid family leave, including providing formal evidence (MATB1 or equivalent). (required)

Privacy notice

The data on this form relates to your request for paid family leave. The date and time of your submission, your identity and the information you have submitted will all be stored, but will not be used for any purpose other than administering and recording your your request for paid maternity leave. Please see our Student Privacy Notice for further information.

The 91福利 is the data controller of any information you have entered on this form and as such is committed to protecting your data and rights in line with applicable data protection law (including the UK GDPR and the Data Protection Act 2018). Please review the privacy information (including privacy notices) provided by the University via the following link, for further information on your rights and how the University processes your personal data: Data Protection.

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