A Leave of Absence request is required for any absence that will be longer than 10 days. Documentation will be required to accompany any leave of absence request. Please use the links below to complete your leave of absence request.

Permanent Full time employees that have been employed for at least 12 months and 1250 hours are eligible for Family Medical Leave of up to 12 weeks per year.  The year of eligibility runs from July 1 through June 30 annually. FMLA is allowed for the birth or placement of a child within one year of birth or placement, to care for an immediate family member, your own serious health condition, and any qualifying exigency arising out of an immediate family member serving on covered active military duty.

If you have any questions regarding leave requests please contact Cindy Simson at csimson@haywood.k12.nc.us or (828) 456-2441 ext 2116.

Please use Internet Explorer when working with these documents.

  1. Leave of Absence Form – to request ANY leave of absence more than 10 days open this page using Internet Explorer, fill in the blanks, print, sign, and return to Cindy Simson in Human Resources
  2. WH-380-E Certif. of Health Care Provider – must be used when requesting Family Medical Leave for self. Print this form, fill in employee information, give to Health Care Provider to be completed and returned to Cindy Simson in Human Resources
  3. WH-380-F Health Certif for Family Member – must be used when requesting Family Medical Leave for the care of an immediate family member. Print this form, fill in employee and family information, give to Health Care Provider of your family member to be completed and returned to Cindy Simson in Human Resources
  4. Employee Rights and Responsibilities Under the FMLA

Please returns forms and doctor’s documentation to the attention of Cindy Simson Human Resources by fax, email, mail, or in person

Fax:  828-456-2438

Email:  csimson@haywood.k12.nc.us

Mail: Haywood County Schools Human Resources Cindy Simson 1230 North Main Street Waynesville, NC 28786

In Person: Email Cindy Simson csimson@haywood.k12.nc.us or call 828-456-2441 ext 2116 for an appointment.