Adoption leave request form

[Company Name]

ADOPTION LEAVE REQUEST FORM

If you wish to make a request to the Company to take Adoption Leave, please complete this form and return it to [your Manager]. In the case of a joint adoption, if you are not the “main adopter” you should not complete this form but you should apply for Paternity Leave and Pay. 

This information will be used to help the Company process your request [and to monitor the Adoption Leave Policy]. This form MUST be returned within 7 days of the date that you were notified of the date of being matched with the child.