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Human Capital Services

Leave Request for (Exempt) Faculty and Staff

PERSONAL INFORMATION

DATES/HOURS OF LEAVE
Vacation and Sick Leave are recorded in 4 hour increments




LEAVE TYPE

OR Choose multiple leave types


Choose just one leave type

REASON
SUPERVISOR
Department TIMEKEEPER

This form may not work on all devices.

Signatures are only required if leave request is printed
instead of being submitted online.




*Other Leave--Disaster Leave-DSE, Donor Leave-DNE, etc.

See instructions for questions about completing this form.