HR Form 6
FACULTY PERSONAL DAY
Employee Name: ________________________________________________
Date(s) of requested personal day: __________________________________
(Limit of two days per academic year)
Reason for personal day:
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
I have given my supervisor at least twenty-four (24) hours notice prior to taking
this leave. I understand that my accrued sick leave will be deducted for personal
days as provided by R.S. 17:3312(b).
Employee: _________________________________________ Date ___________
Dean: _____________________________________________ Date ___________
Vice Chancellor for Academic Affairs: _________________ Date ___________
Approved _______ Disapproved _______
Appointing Authority: _______________________________ Date ___________
Print Form