Name:
Employee ID:
Employee Program/Area:
Absence Form Campus:
Please forward completed form to Human Resources (Metro Campuses - K105, Northern Campuses - C. Arkinstall, AC118A)
Winter/Spring 2009 VACATION If part-time, complete work schedule
NASA Reading days are Feb 17&18, 2009. Pay periods are separated by Wk 1: M T W T F
lines in the calendars below.
Wk 2: M T W T F
JANUARY FEBRUARY
S M T W T F S S M T W T F S
1 2 3 1 2 3 4 5 6 7
4 5 6 7 8 9 10 8 9 10 11 12 13 14
11 12 13 14 15 16 17 15 16 17 18 19 20 21
18 19 20 21 22 23 24 22 23 24 25 26 27 28
25 26 27 28 29 30 31
= _______ days vacation = _______ days vacation
MARCH APRIL MAY
S M T W T F S S M T W T F S S M T W T F S
1 2 3 4 5 6 7 1 2 3 4 1 2
8 9 10 11 12 13 14 5 6 7 8 9 10 11 3 4 5 6 7 8 9
15 16 17 18 19 20 21 12 13 14 15 16 17 18 10 11 12 13 14 15 16
22 23 24 25 26 27 28 19 20 21 22 23 24 25 17 18 19 20 21 22 23
29 30 31 26 27 28 29 30 24 25 26 27 28 29 30
31
= _______ days vacation = _______ days vacation = _______ days vacation
Please circle,
highlight, or
otherwise indicate *For all absences other than vacation (eg. Layoff, Leave without Pay, etc.),
days of vacation. please submit an Employee General Absence Form available on NAIT
eForms at www.nait.ca/eforms.
Employee Signature Supervisor's Signature Date
*YOUR LIFE INSURANCE / LONG-TERM DISABILITY INSURANCE IS NOT
HR502 09/19/2008
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: to
mm.dd.yyyy mm.dd.yyyy
Business Travel: yes no or Vacation/Personal Leave: paid unpaid
Dates of Travel: 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: yes no
If yes, please answer the following:
This benefit coverage will be effective on:
mm.dd.yyyy
Please discontinue my coverage with NAIT as of:
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 cover-
age via e-mail.
Eform#HRLV18Revised09/17/2008