CAREER BREAK APPLICATION FORM

Transcription

1 CAREER BREAK APPLICATION FORM Download and save this form before completing. This form is online and it is not intended that it is printed - it can be ed and signed electronically (see guidance at the end of this form). Before completing this request, please read the Work Life Balance Policy. Text boxes have a character limit - you write more but it will not be visible if you choose to print it. You must submit this application at least 6 months before you intend to start your leave. 1. CAREER BREAK REQUEST (TO BE COMPLETED BY THE EMPLOYEE) Name: Job Title: Department/Section: Contact Details: Line Manager: University Employment Start Please note you must have been continuously employed for 2 years before the date of commencement of the career break. Do you have a permanent contract of employment: Please note you must have a permanent contract (either full or part-time) to be eligible for a career break. o YES o NO 2. PURPOSE OF THE CAREER BREAK (TO BE COMPLETED BY THE EMPLOYEE) A) extend the standard maternity/paternity/adoption leave o B) care for an elderly relative o C) to undertake long term, full-time study o E) to visit relatives abroad o F) Other (please give details): D) to travel or work on a voluntary basis (e.g. to accompany a partner working abroad) o

2 3. DETAILS OF THE CAREER BREAK (TO BE COMPLETED BY THE EMPLOYEE) Proposed length of the career break: 1 Proposed start date: Have you taken a career break on a previous occasion? (as an employee of the University of Essex) Proposed return to work date: o YES o NO 4. IMPACT OF PROPOSED CHANGES (TO BE COMPLETED BY THE EMPLOYEE) What effect if any will the proposed changes have on: A) your work and service B) your department/faculty C) your colleagues and other members of your team 1 A career break will normally last between three months and one year, but in exceptional cases, and where practicable, a career break of less than three months or more than one year (up to 2 years) may be taken.

3 D) your service users, e.g. other staff, students Do you have any suggestions for how the impact of the requested career break arrangement(s) can be addressed? What advantages/ disadvantages (including any additional costs) does this requested career break involve? Do you have any other comments that you wish to have taken into consideration?

4 5. EMPLOYEE DECLARATION AND SIGNATURE n I declare that the information I have provided is accurate ni acknowledge that the University may refuse my request for a career break on reasonable operational grounds n I acknowledge that this request is conditional upon and subject to approval by the Executive Dean/Registrar & Secretary. n If approved I understand that a trial period and an annual review may be put in place to ensure the operational needs of the department can continue to accommodate the flexible working arrangement. Employee s signature: (*See guidance at the end of this form) TO BE COMPLETED BY THE HEAD OF DEPARTMENT/SECTION On receipt of this Career Break Request application, you should arrange a meeting with the employee and their line manager to discuss the application. Factors to take into account when considering the request include: n The purpose of, or reasons for, the career break; nthe period of absence requested; n Whether the employee has taken a career break on a previous occasion; nthe operational needs of the Department; n The need to retain key skills, knowledge and experience to achieve the University s longer term strategic objectives and ensure that staff expertise is aligned to student demand/priority activities. n The potential to be able to cover the post on a temporary basis; n The potential for the employee to return to a similar / the same post; nthe potential benefits to the Department / University/ individual employee. Head of Department/Section recommendation (after having met with the applicant) Head of Department signature: (*See guidance at the end of this form)

5 TO BE COMPLETED BY THE EXECUTIVE DEAN/ REGISTRAR & SECRETARY Executive Dean/Registrar & Secretary: Specify any amendments o APPROVED o REJECTED o APPROVED WITH AMENDMENTS Reasons for rejection: the burden of additional costs o an inability to reorganise work amongst existing staff o an inability to recruit additional staff o a detrimental impact on quality o a detrimental impact on performance o detrimental effect on the ability to meet customer demand o insufficient work for the periods the employee proposes to work o a planned structural change to the business o

6 Additional comments: Executive Dean/Registrar and Secretary signature: (*See guidance at the end of this form) The Executive Dean/Registrar should return this form to the link HR Manager/Officer so that HR can confirm the decision in writing to the individual. * To sign the form, click "fill and sign" and then "sign". Signatures can be done in three ways: typing your name, writing your signature using your mouse, uploading a JPEG image of your signature. Once signed, the form cannot be amended - this is to protect the form. Before you print: remember, this form is not intended to be printed. If any text boxes contain more text than the character limit, this will not be visible when printed.