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Adobe Acrobat Reader (shareware) must be installed on your computer to print or complete the PDF forms. The complete Adobe Acrobat software (not shareware) is required to save a completed PDF form.

Rich Text Format (RTF) forms may be used by any word processor (Word, Works, WordPerfect, etc.) and do not require special software.

Form directions and/or additional information are provided in the Instructions or Information Column or within the form.

Technical Support for Forms:
Kathy Kugle (785) 532-1885
or email kkugle@ksu.edu

Division of Human Resources
Kansas State University
103 Edwards Hall
Manhattan, KS 66506-4801
785-532-6277
785-532-6095 (fax)
8 a.m. - 5 p.m. (CST)
Contact HR

Leave Request for Hourly (Non-Exempt) Employees

PERSONAL INFORMATION
Name:	E-mail Address:
DATES/HOURS OF LEAVE—Recorded in 15 minute increments
From Date: From Time:
To Date: To Time:
Total Hours Requested
LEAVE TYPE
REASON FOR OFFICIAL OR *OTHER LEAVE
If taking Official leave or Other leave, please specify the reason:
SUPERVISOR'S E-MAIL ADDRESS (Required for submission)

Employee's Signature Date
Supervisor's Signature Date

*Other Leave--Disaster Leave-DIS, Donor Leave-DON, etc.
Leave Request Instructions

Is this Family Medical Leave Act related? If yes, refer to FMLA

Kansas State University

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Leave Request for Hourly (Non-Exempt) Employees

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