Application for family medical leave employee contact information: (please print clearly using a black pen.) name: employee number: mailingaddress: home /cell telephone: work ext.: position: dept/unit: facility: immediate supervisors name: ext.:...
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Concordia college office of human resources leave of absence request form section 1: to be completed by the employee name: preferred phone: supervisor: work schedule: s m t w th f department: preferred email: support staff administration faculty s...
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4/01 kedc sick leave request and work calendar change/request form printed name: date: sick or personal leave this form must be completed on the date you return to work after taking sick leave or emergency leave. personal days must be requested...
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Cdta leave of absence request for a part time sd71 teacher date of submission: to: linda glennon, sd71 payroll supervisor attachment pdf via email: linda.glennon sd71.bc.ca from: shirley miller, cdta executive secretary via email: office71...
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Independent school district #535 615 7th st sw rochester, minnesota 55902 hr department telephone (507) 3284251 fax (507) 3284206 employee: todays exam date: date of injury/event: next exam date: employees regular job title: department: the...
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Request for leave application leave of absence & fmla to be completed by employee requesting leave: employee name: id# (for hr use only) date of hire: employee status: faculty staff adm. department: division: work schedule: (for faculty only,...
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Request for leave of absence (form 1001) section 1: personal information (staff member completes sections 1 and 2 and returns completed form to supervisor/manager) last name: first name: duke unique id: home address: phone (work): department: date...
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State of west virginia application for leave of absence without pay name: work unit/section: division: i am making application for the following leave of absence: g personal without pay g educational without pay g military without pay period of...
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Submit a leave absence request quick reference purpose use this procedure to submit requests for the following leave absences: annual leave used to record annual leave. the leave amount can be taken at any time provided sufficient time has been...
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Wssu graduate studentleave of absence requestleave of absence guidelines:if a graduate student requests and is granted a leave of absence, reenrollment mustoccur in the term agreed to in the leave request. if a student fails to continue in the...
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New york city department of education - division of human resources and talent hr connect - medical, leaves & records administration waiver to work while on study sabbatical leave of absence application in order to request a waiver to work while...
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Leave of absence request form employees name department extension street city/town state home telephone work telephone date of hire zip type of leave: check one below date leave starts expected return date employees own illness1 military (attach a...
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Military leave of absence application employee s name: ssn: branch of service: check one: reserve member national guard member volunteer employee position title: supervisor: employee hire date: date notified for military duty: name of military...
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East side union high school district certificated unpaid leave of absence request form name: site: loa for year: reason for request: i understand that this request is for an unpaid leave without benefits initials initials initials i understand...
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