2016 CBA
Tentative Agreement
Page 197 of 217
Appendix Article 31 - 1
Nursing Mothers Program Form
NATCA/FAA Nursing Mothers Program Form
Employee's Name:
Facility/Area:
In accordance with Article 31 of the Parties CBA, I require the use of a private area to express milk during
work hours begi nning on ____________.
The private area shall be a space other than a bathroom that is uninterrupted, shielded from view, provides
predictable privacy, is not accessible through another room and is free from intrusion from co - workers and the
public.
I un derstand that it is my responsibility to advise you when my ongoing requirement to express milk during
work hours is no longer necessary.
Employee's Signature: Date: / /
Manager's Signature: Date: / /
