Name: Employee ID:
Employee Absence Form
Program/Area: Campus:
Please forward completed form to Human Resources (Metro Campuses - K105, Northern Campuses - C. Arkinstall, AC118A)
Winter/Spring 2009 VACATION
NASA Reading days are Feb 17&18, 2009. Pay periods are separated by lines in the calendars below.
If part-time, complete work schedule Wk 1: M Wk 2: M T T W W T T F F
JANUARY
S 4 11 18 25 M 5 12 19 26 T W T 1 F 2 S 3 10 17 24 31 S 1 8 15 22 M 2 9 16 23
FEBRUARY
T W T F S 7 14 21 28 3 4 10 11 17 18 24 25 5 6 12 13 19 20 26 27
6 7 13 14 20 21 27 28
8 9 15 16 22 23 29 30
= _______ days vacation
= _______ days vacation
MARCH
S 1 8 15 22 29 M 2 9 16 23 30 T W T F S 7 14 21 28 S 5 12 19 26 M 6 13 20 27 T 3 4 10 11 17 18 24 25 31 5 6 12 13 19 20 26 27
APRIL
W 1 7 8 14 15 21 22 28 29 T 2 F 3 S 4 11 18 25 3 10 17 24 31 4 11 18 25 5 S M T
MAY
W 6 T 7 F 1 8 S 2 9 16 23 30
9 10 16 17 23 24 30
12 13 19 20 26 27
14 15 21 22 28 29
= _______ days vacation
= _______ days vacation
= _______ days vacation
Please circle, highlight, or otherwise indicate days of vacation.
*For all absences other than vacation (eg. Layoff, Leave without Pay, etc.), please submit an Employee General Absence Form available on NAIT eForms at www.nait.ca/eforms.
Employee Signature
Supervisor's Signature
Date
HR502 09/19/2008
*YOUR LIFE INSURANCE / LONG-TERM DISABILITY INSURANCE IS NOT AUTOMATICALLY COVERED UNDER ALL CIRCUMSTANCES. (SEE PAGE 2)
Personal or Business Leave of Absence Information LV-18
Employee Name Employee #
Section 1 - Travel Dates and Destinations are required to validate insurance coverage if you will be travelling on NAIT Business or travelling outside Canada/US on vacation or personal leave. Dates of Absence: from:
mm.dd.yyyy
to
mm.dd.yyyy
Business Travel: Dates of Travel:
yes
no
or
Vacation/Personal Leave:
paid
unpaid
To City/Country:
mm.dd.yyyy mm.dd.yyyy mm.dd.yyyy
Section II - Employees working for another employer or self-employed are required to elect group benefit coverage with the new employer whenever possible. NAIT group benefits may be continued if alternate coverage is not available and the type of work is allowed under NAIT's contract with the insurance carrier. Name of Employer: Dates of Employment:
starting mm.dd.yyyy ending mm.dd.yyyy
Job Duties: I will be eligible for benefit coverage with this employer: If yes, please answer the following: This benefit coverage will be effective on: Please discontinue my coverage with NAIT as of:
mm.dd.yyyy
yes
no
mm.dd.yyyy
Section III - Required for Academic staff taking courses during their leave. See Section 24 of NAIT/NASA agreement. Name of Institution providing courses: Names of courses/programs to be taken:
Applicant's Signature
Date
Employees travelling outside of Canada/US or working for another employer will be notified of benefit coverage via e-mail.
Eform#HRLV18Revised09/17/2008