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Leave Request Form
Please enter the following information:
Employee ID #:
Select type of leave:
Excess Annual Leave
Off-Campus Time (professional development, conferences, or work/student related activities)
Juror or Witness Leave
Public Service Leave
For any Off-Campus time additional documentation may be requested.
Please select the type of Off-Campus leave you are requesting:
Work/Student Related Activities
Applicable for AY faculty members ONLY.
CBA eligible faculty members ONLY
DOCUMENTATION IS REQUIRED
Please provide additional documention to your supervisor.
Date(s) of requested leave:
Number of hours claimed:
Please enter your supervisor's email address for approval:
to approve this document - this acts as your digital signature.
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