Dr. Valerie Kelsey, Superintendent
Schalmont Central School District
4 Sabre Drive
Schenectady, New York 12306

Dear Dr. Kelsey:

On (date), I gave birth to a baby( sex). I am requesting an unpaid leave of absence for child rearing purposes commencing on (date) and ending on (date). Also, I wish to exercise all my rights under the Family and Medical Leave Act.

It is possible I may wish to extend this leave. I will keep the Board of Education informed of my intentions.

Sincerely,

Name