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Sick Leave Bank
Donation Form

The purpose of the Sick Leave Bank is to provide eligible University employees with a means of financial support in the event they or an immediate family member is subject to catastrophic illness or injury and face a hardship because they do not have adequate accumulated leave time or other available income. 

To fund the Sick Leave Bank, employees are able to contribute a minimum of one day and a maximum of five days of their own accumulated sick leave time to the bank.  Employees who wish to contribute to the Sick Leave Bank may not do so unless they have at least ten days of their own sick time remaining after making a donation. 

Contributing employees may not designate a particular individual to receive their donation.  Contributing to the Sick Leave Bank is not a requirement to apply for benefits. 

Please see the Sick Leave Bank Policy for complete details. 

If you wish to support the Sick Leave Bank, please complete this form and return it to Human Resources, CPO 24-A

Check the box next to the number of days you wish to contribute to the Sick Leave Bank
The number of hours to be donated is determined based on your employee classification, regardless of any modifications made to your daily work schedule. For example, if you're classified as a 7.5 hour per day employee, then 7.5 hours will be deducted for each day chosen above.
Thank you for your contribution.
Updated 12/8/2009


Eastern Kentucky University is an Equal Opportunity/Affirmative Action Employer and Educational Institution.