![](https://var.fill.io/uploads/pdfs/html/a582c922-49fb-48c2-ad2b-1a41ef428211/bg1.png)
KINGSBOROUGHCOMMUNITYCOLLEGE
OFTHE
CITYUNIVERSITYOFNEWYORK
REQUESTFORANNUALLEAVE
Irequestannualleaveforthefollowingperiod(s):
____________________ __________________________________________________
Date Name
Request
_____Approved
_____Denied(Ifdeni ed,thereasonshouldbeprovided)
Alternatedatespr ovided__________________________________________________________________
___________________ __________________________________________________
Date Supervisor
SeniorExecutiveLevel
Dateofr eceiptofr equest________________
Actiontaken:___________________________________________________________________________
___________________ __________________________________________________
Date MickieDriscoll
Distribution
WhiteCopy: Employee
CanaryCopy: Supervisor
PinkCopy: OfficeofHumanResources
M76