EASTERN KENTUCKY UNIVERSITY
SICK/VACATION REQUEST
(Faculty and Professional Staff Form)
     
Printed Name (Last, First) EKU ID# Campus Phone

Requesting:  
Leave Code FROM:
ex. 1/09/00
TIME:
ex. 8:00 AM
  TO:
ex. 1/14/00
TIME:
ex. 4:30 PM
  TOTAL:
ex. 37.50 Hours
           
           
           
           
           
 
Total Sick Requested: Total Vacation Requested:
Total Bereavement Requested: Total Floating Holiday Requested:
IMPORTANT: Leave request forms must be turned in to Payroll as near to the date taken and preferably within the pay period that they occurred.
   
Employee Signature Date Signed
   
Supervisor Signature Date Signed
   
Dean (If required) Date Signed
   
Vice President (If required) Date Signed
 
Return completed form to Payroll, Coates Box 3A
 
System Processed Date HR Employee Initials/Date Comments
       
ch 3/23/01