Fillable REQUEST FOR LEAVE Date Type of leave requested: (Northeastern Oklahoma A&M College)

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REQUEST FOR LEAVE Date Type of leave requested: (Northeastern Oklahoma A&M College)

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________________
REQUEST FOR LEAVE
Date
Name:_______________________ Campus ID:________________Dept:_____________
Type of leave requested: □ Annual Leave □ Sick Leave □Leave without pay
□ Military Leave □ Other__________________________
Period of leave: Beginning Date:__________________Ending Date:_______________
Total hours leave will cover:_______________(You may be charged with the number of
hours requested: any deviation will
require an additional form to be
submitted.)
I request a leave of absence for the dates above:_______________________________
Signature of Employee
Approved:______________________________________Date:____________________
Supervisor
Approved:______________________________________Date:____________________
President/Vice President/Dean
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REQUEST FOR LEAVE Date Type of leave requested: (Northeastern Oklahoma A&M College)

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Completed 26 July 2020

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