Absence Report Form Art Department
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ABSENCE REPORT FORM
ART DEPARTMENT
This form will be used to report sick or funeral leave and to request personal leave and
absences due to professional or business related travel and jury duty (or other court required
services as permitted by the agreement).
In accordance with University Policy and Procedures sick, personal, funeral and jury duty leave
will be reported to the Payroll Office. You will be provided a copy of the form(s) for your records.
Application for Travel Form should be completed and attached to this form. For reimbursement
and university insurance purposes Application for Travel forms must be approved prior to
requested professional or business related travel leave.
Name: ________________________________________________________________
Type of Leave: ___ Sick ___ Personal ___ Professional Travel
___ Funeral ___ Jury Duty
Date(s) Absent: ________________________________________________________
Number of Days Taken: _______
If classes will be missed, describe the arrangements you have made:
Date
Course _____
Details on Class Projects, Etc. During Your Absence__
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Name of Substitute (if applicable): _____________________________________________________
Your Signature _______________________________________________ Date __________________
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