Leave of Absence by Z5Ja5XZ

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									                                                                                    Office of Human Resources
                                                   Leave of Absence
                                                                                     Personnel Action Request

ID Number: T                                                      Address 1
Last Name:                                                        Address 2
First Name:                                                       City
Middle:                                                           State                  Zip
Department:

Type of Leave:
First date of leave:
Date of Return to Work:
Special Conditions:




                                                PEOPLEADMIN ROUTING

Requestor to Department Head to Dean/Director to VP/Provost to Title III* to Grants* to Budget to Human Resources
to EDC
                                                                    *if grant funded

1. Complete form and save to your drive/network folder.           3. Attach completed form to PARF action.
2. Begin new PARF action in PeopleAdmin.                          4. Track action to make sure routing does not stall.

								
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