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Leaves

TO SUBMIT YOUR LARS ELECTRONICALLY, SCAN ALL OF THE LARS AND EMAIL TO:

Harizon Odembo: hodembo@peralta.edu

Alejandra Rodriguez: alejandrarodriguez@peralta.edu

Anthony Matchette: amatchette@peralta.edu

*Please include all three in the email.

*Please DO NOT send the LARs in separate emails for each person.

Contact Alejandra Rodriguez at alejandrarodriguez@peralta.edu if you have any questions regarding leaves benefits.

FORM FOR REQUESTING MEDICAL LEAVE

Medical Leave Request Form – revised 2019

FMLA & CFRA INFORMATION

FMLA Information (Eligibility Criteria)

FMLA Form – Employee’s Serious Health Condition

FMLA Form – Family Member’s Serious Health Condition

LEAVE OF ABSENCE REPORTING FORMS

COVID-19 sick leave reporting new

2020 Admin/Classified LAR 

2020 Comp/Overtime Form

2020 Faculty/Adjunct LAR

2020 Hourly/Student LAR

2019 Admin/Classified LAR

2019 Comp/Overtime Form

2019 Faculty/Adjunct LAR

2019 Hourly/Student LAR

Archived LARs

Click here for instructions on how to complete the LAR form. 

Employee Leave Request (Individual Leave Request)

Unpaid Leave of Absence Request

  • Human Resources

    Monday 25 May 2020
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  • Since 1964, the Peralta Community College District - comprised of Berkeley City College, College of Alameda, Laney College and Merritt College - has served the cities of Alameda, Albany, Berkeley, Emeryville, Oakland and Piedmont by providing 25,000 students each semester with a range of educational programs and life-long learning opportunities
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