PAT Sick Leave Bank Contribution Form
This voluntary program was established to help professional educators in the PAT bargaining unit who are suffering from an extended personal illness or injury. Educators who have exhausted their accumulated sick leave may apply for hours from the Sick Leave Bank.

All PAT bargaining unit members are encouraged to contribute sick leave hours in aid of fellow educators. The PAT Sick Leave Bank is funded solely by voluntary contributions from PAT educators. Sick Leave Bank contributions may be made only to the Bank and not to specific individuals.

You may contribute up to forty (40) hours of sick leave annually. Employees who have submitted notice of resignation are exempted from this maximum limit, and may contribute as many hours as they would like.

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Email *
First Name *
Last Name *
PPS Employee ID # *
Home Address *
Home Telephone *
School Telephone
Title/Position *
School/Site *
PPS Email Address *
Hours to Donate

You may contribute up to forty (40) hours of sick leave annually.

Employees who have submitted notice of resignation are exempted from this maximum limit, and may contribute as many hours as they would like.
I wish to donate the below number of hours to the PAT Sick Leave Bank: *
By checking this box, I authorize PPS to transfer the above-listed number of my sick hours to the PAT Sick Leave Bank. *
Required
A copy of your responses will be emailed to the address you provided.
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