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Title:	Request for Leave of Absence
Summary:
Description:
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Handle:	Document-18463
Owner:	Hanson, Jean (User-867, 07736:EVERETT)^DS
Create Date:	Friday, October 24, 2008 11:53:01 AM PDT
Modified Date:	Wednesday, March 26, 2025 02:14:00 PM PDT
Modified By:	Mulvaney, Linnea (User-5348, 14156:EVERETT)^DS
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Abstract:	Revised 1/14/2020 Required for absences of five or more working days (except approved vacation)Required for all leave without pay regardless of number of work daysEMPLOYEE NAME: ID NUMBER:WORK LOCATION: POSITION:I request a leave of absence for the period of throughExpected first day of leave Expected last day of leaveI am requesting a ? full-time ? part-time or ? intermittent (hours/days as needed)List leave hours per day or FTEReason for this request: (mark all that apply) ? Medical ? Self or ? Family Member ...
Add Versions:	Allowed
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Content Type:	Adobe Portable Document Format (.pdf) - application/pdf
File name:	LEAVE OF ABSENCE FORM Update.pdf
Is Placeholder:	No
Max Versions:	4
Size:	654174
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Last Synchronized:
Ready for Declare:	No
Appears In:	LEAVE OF ABSENCE INFORMATION
Preferred Version:	Request for Leave of Absence