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4. ALL TOWN EMPLOYEES ARE REQUIRED TO ACKNOWLEDGE RECEIPT OF THE DOMESTIC VIOLENCE LEAVE POLICY.
   This policy was adopted pursuant to the Massachusetts Domestic Violence Leave Act, G.L. c. 149, §52E. This law describes the rights and eligibility for leave for victims of domestic violence and the responsibilities of employers including those related to notification requirements and confidentiality.
10. YOUR INFORMATION
14. First Name:
15. Last Name:
16. Position/Title/Role:
18. Email Address:
19. Primary Phone Number:
21. Department/Board/Committee Name:
27. ACKNOWLEDGEMENT OF RECEIPT OF DOMESTIC VIOLENCE LEAVE POLICY
31. Enter Your Full Name:
    By typing your full name above you are acknowledging that you have received and read the Domestic Violence Leave Policy
32. Date of Receipt:
    Date of Receipt:
38. SUBMIT YOUR ACKNOWLEDGMENT AND RECEIPT
42. Leave the box below checked and enter your desired email address to recieve a copy of your form submission:
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44. 1. Receive an email copy of this form.
45. Email address

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46. Submit

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