Leave Request for Salaried Employees | Leave & Holidays | Benefits | Human Resources

PERSONAL INFORMATIONName:
E-mail Address:

DATES/HOURS OF LEAVE
Vacation and Sick Leave are recorded in 4 hour incrementsFrom Date:
From Time:
To Date:
To Time:
Total Hours Requested

LEAVE TYPE

Choose Just One:

Vacation Leave VAE
Hours and dates

Sick Leave SCE
Hours and dates

Parental Leave PLE
Hours and dates

Funeral Leave FNE
Hours and dates

Jury Duty JRE
Hours and dates

Military Leave MIE
Hours and dates

Leave Without Pay LWP
Hours and dates

Discretionary Day DDE Date

Holiday Compensatory Time HCE
Hours and dates

Other Absence
Type, Hours and dates

REASONReason for Leave or Other Absence (Optional):

SUPERVISORSupervisor's E-Mail Address (Required for submission)

Department TIMEKEEPERTimekeeper's E-Mail Address (optional)

This form may not work on all devices.

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

Employee's Signature
  Date
Supervisor's Signature
  Date

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

See instructions for questions about completing this form.

Kansas State University