Leave Request for Hourly (Non-Exempt) Employees

Leave requests after October 26, 2025, need to be made in the Time and Leave System. To learn more about the new system, review the Time and Leave System Website.

See instructions for questions about completing this form.

Employees must fill out all fields in the Personal Information and Dates/Hours section and include their supervisor and timekeeper's email address to submit leave. These fields are required.

PERSONAL INFORMATION First and Last Name: Email Address:

DATES/HOURS OF LEAVE

Recorded in 15 minute increments

From Date: From Time: To Date: To Time: Total Hours Requested:

LEAVE TYPE

Choose One:

Vacation Leave VAC | Hours and Dates:

Sick Leave SCK | Hours and Dates:

Parental Leave PLV | Hours and Dates:

Funeral Leave FNL | Hours and Dates:

Jury Duty JRY | Hours and Dates:

Military Leave MIL | Hours and Dates:

Leave Without Pay | Hours and Dates:

Discretionary Day DDY | Date:

Compensatory Time CMT | Hours and Dates:

Holiday Compensatory Time HCT | Hours and Dates:

Other Leave
Type, Hours and Dates:

*Other Leave: Disaster Leave-DIS, Donor Leave-DON, etc.

REASON Reason for Leave / Other Absence:

SUPERVISOR Supervisor's Email:

DEPARTMENT TIMEKEEPER Timekeeper's Email:

-- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- --

This form may not work on all devices.

Signatures only required if printing request instead of submitting online.

Employee's Signature: Date: Supervisor's Signature: Date:

KSU Policy and Procedures Manual Chapter:

4860 Employee Leaves, Holidays, and Other Absences for Employees of Kansas State University

Related Information:

Leave Programs