ࡱ> [^XYZa bjbj 4F\F\ a t$"%N   V@T@Uj 1 0a x%;L%T%Tx  a %> V:  APPENDIX B1  APPLICATION FORM FOR ADOPTION LEAVE AND PAY - OVERSEAS Please read the Colleges Adoption Leave Guide, and discuss your situation with the HR Department before completing this form. Correct completion of this form will help to protect your entitlement to adoption leave and pay, as well as your right to return to work. Name:. Department:.. Date I received Official Notification: Date my child is expected to enter the UK:. Proposed adoption leave start date: Please tick the statements which apply to you I confirm that I have received Official Notification I confirm that I have informed my line manager that I am adopting I confirm that I wish to retain my right to return to work I am certain that I will not be returning to work after my adoption leave. I will give the College at least 8 weeks notice if I intend to change my return to work date I have enclosed with this form my Official Notification Declaration: I have read the Colleges Adoption Leave Guide (Overseas), and I agree to the following: I will reply to all correspondence from the College within the required time. I understand that I may lose my right to return to work if I do not do so. I understand that the Occupational Adoption pay is paid on the condition that I return to work for at least 3 months. I agree to repay this money if I do not return to work for 3 months. I also agree that the College can recover any monies due from any other payments owed to me (eg: for unused annual leave) Signature:.Date: Please return this form to HR no later than 28 days after the date of receipt of the Official Notification. .6=LS^_`c 1   ! 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