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This Electronic Form may be executed by electronically transmitted signatures, (either Penned Bitmapped Signature or Typed Name), and such signatures shall be deemed to be as valid as an original signature whether or not confirmed by delivering the original signatures in person, by courier or by mail.

Please take the following two steps:

-Submit this form to Human Resources. 

-Email your supervisor, indicating that you have requested family and medical leave.  In your email, indicate the number of days you have requested leave and the approximate timeline.  However, you do not need to indicate the specific reason for the leave (e.g., serious health condition of a family member, childbirth...).