Clear Creek Amana School District
Employee FMLA Leave Request


Note: * Please fill out all required fields below.

Step 1: Complete the information below and Click Submit.


Date:    10/30/25
Salutation:   
* First Name:   
* Last Name:   
Employee #:   
* Email:   


Note: The email address above should be the email that you use to communicate with Clear Creek Amana School District.

Please be advised that you must follow our usual and customary notice and procedural requirements for requesting leave.