California Lutheran University
Mo
nthly Faculty Sick Time
Please indicate the days off when you were sick by placing an “X” next to the date during the month of
{ }. Return the completed form within a week. Save this form as a Word document for
your records and attach the form in an email to payroll@callutheran.edu.
DAY DAY DAY DAY DAY DAY DAY
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Comments:
Employee Name:
Note: This form is set up like a calendar, with space for 31 days. Sick time may be used for the illness of an
employee or an eligible family member; preventive care, diagnosis, care of treatment of an existing health
condition for an employee or an employee’s family member; or for specified purposes if an employee is a
victim of domestic violence, sexual assault or stalking. You can view the full sick leave policy at:
https://earth.callutheran.edu/hr/employee_handbook.php