As a certified employee of Jefferson Joint School District 251, I hereby apply to become a member of the Sick Leave Bank. I authorize Jefferson Joint School District 251 to deduct two (2) days of my earned sick leave to be contributed to the Sick Leave Bank. I further understand that by authorizing this, I will be a member of the Sick Leave Bank unless a written request is provide to the district to be removed from the sick bank. I understand that if I resign or retire, the sick leave days donated to the Sick Leave Bank remain in the bank and are forfeited by myself. I understand that I cannot apply to use days from the sick leave bank if I am receiving workmen’s compensation or for maternity leave.
The District Office must receive all applications by November 1 of the current school year or prior to any illness for which a claim is made, whichever is earlier.