Leave Request Form
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Department of Biology
LEAVE REQUEST FORM
Name:
Date:
Request for
Sick
Personal
Annual
days
Dates:
I have leave available for this request:
Yes
No
Reason for leave:
Staff Member:
(signature)
(date)
Approved: Yes: _____ No: _____
(supervisor signature)
(date)
Reason for disapproval: __________________________________________
Note: Requests for one day or two consecutive days leave must be requested
two days prior, except in cases of documented emergencies. Requests for
leave in excess of two consecutive days must be requested one week in
advance, except in cases of documented emergencies.
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