Fillable EASTERN ILLINOIS UNIVERSITY REQUEST FOR SICK LEAVE BANK (Eastern Illinois University)

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EASTERN ILLINOIS UNIVERSITY REQUEST FOR SICK LEAVE BANK (Eastern Illinois University)

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EASTERN ILLINOIS UNIVERSITY
REQUEST FOR SICK LEAVE BANK USAGE
NAME
E#
RANK/TITLE
C.S. FAC/A&P
DEPARTMENT
HOME PHONE
HOME ADDRESS
NUMBER OF SICK LEAVE DAYS REQUESTED:
Signature of Employee Date
ONLY EMPLOYEES WHO HAVE DONATED TO THE POOL ARE ELIGIBLE TO REQUEST SICK
LEAVE FROM THE POOL.
FORWARD TO BENEFIT SERVICES
Approved By Date
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EASTERN ILLINOIS UNIVERSITY REQUEST FOR SICK LEAVE BANK (Eastern Illinois University)

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Completed 20 August 2020

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