Maternity / Adoption Leave

Return to Work Form

Before completing this form, please read the UECS Family Leave Policies document.

You should download this form and save it on your computer before completing it.

Employee Details

Surname:	Click to enter text	Forename/s:	Click to enter text
Department:	Click to Select	Contact Telephone Number:	Click to enter text
Home Address:	Click to enter text

Maternity / Adoption Leave Return Details

You should give at least 8 weeks’ notice of your intended return to work date. You should take all accrued annual leave before you return to work. People & Culture can confirm the amount of annual leave you have accrued.
Child’s date of birth:	Select Date …	Child’s date of adoption:	Select Date …
Last date of Maternity / Adoption Leave	Select Date …	Return to work date (after taking accrued annual leave):	Select Date …

Employee Signature

Print name:	Click to enter text	Date signed:	Select Date …
Signature:
Sign the form by either typing your name or uploading a JPEG image of your signature. Save the completed form and send it by email to People & Culture.