Annual Leave/Vacation Request Form
Employee Name
Date
Vacation Request Start Date Return to Work Date Total Work Days Off
Employee Signature* Date
*If your department permits this form to be emailed for approval, your @emich.edu email is
your signature.
This Vacation Request is:
Denied
Reason:
Granted
Supervisor Name or Signature** Date
** Electronic approval permitted at supervisory level.
Please follow your department’s procedures for requesting time off. Vacation/ Annual
L
eave should be requested at least five days in advance. Supervisors are to keep the form
on file in accordance with the department’s procedures.
Important notice for employees with less than one year of service; You must complete the
“Request to Use Annual Leave” form at this link and return it to the Payroll Office prior to
taking annual leave/vacation. For questions, please contact Payroll at 734-487-2393 or via
email at payroll.questions@emich.edu.
