Walla Walla Community College
Request/Report of Absence
Employee SID
Last Name
First Name
Department:
Employee Type
Faculty Part-time Faculty
Leave Beginning
Leave Ending
Total Hours Requested
AM
PM
Month/Day/Year
Hour
AM
PM
Month/Day/Year
Total Hours
Personal Holiday ______ hours*
Leave Without Pay ______ hours
Bereavement Leave ______ hours
Other ______ hours (Specify) _________________
Date Received:
Date Posted : ______________
Processor Initial: _______
Type of Leave Taken Payroll Use Only
Sick Leave ______ hours*
If Applicable:
FMLA (Apply via HR office)
Job Related Injury/Illness
Explanation of Leave (if other than sick)
Employee Signature
Date of Request
Supervisor AND/OR Administrator Signature
Date Approved
* Compensation for leave cannot exceed the total amount of leave accumulated. Should leave be approved in excess of the total accumulated, it will be taken as leave
without pay
WHITE: Payroll PINK: Supervisor/Support Staff GOLD: Employee