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School of Technology Absence Request

School of Technology absence request form for Unit A and B faculty

Name Name First Last
Email
Employment status:

Employment status: Unit A faculty Unit B faculty
Section Break

This is the description of your section break.
Date of Absence Date of Absence / MM / DD YYYY
Type of Used Leave:

Type of Used Leave: Accrued Leave Family Sick Leave (FMLA) Bereavement Leave (up to 5 days per occurrence) Travel Sick Leave (up to 5 days per academic year) Personal Leave Court Required Leave Leave without salary Other Other
Total Hours:
Leave Reported in Quarter-Hour Increments *
List these dates/times here if a full day (7.5 hours) was not taken for any of these (e.g., 3/1/24 gone from 2-4:30pm and missed office hours). *
How are you covering your responsibilities while absent?
Example: GA Coverage, Online Assignment *
If you need a message posted on your office or classroom door, provide the room number and message text. *