Dept. of Human Services Absence Notification Form - Unit A & B
Dept. of Human Services Absence Notification Form - Unit A & B
Name:
Name:
*
First
Last
Email:
*
Employment Status:
*
Employment Status:
Unit A Faculty
Unit B Faculty
Date of Absence:
Date of Absence:
*
/
MM
/
DD
YYYY
Total Hours:
Leave Reported in Quarter-Hour Increments
*
Type of Used Leave:
*
Type of Used Leave:
Accrued Leave
Sick Leave
Family Sick Leave
Personal Leave
Bereavement Leave
Court Required Leave
Leave without Salary
Travel
Other
Other
Which activities will you miss while absent?
(check all that apply)
*
Which activities will you miss while absent?
(check all that apply)
Class Hours
Office Hours
Departmental Meeting
Other
Other
List each missed activity, including the days/times and location.
Example: Office Hours Wed 2-4p KH 2020
*
How are you covering your responsibilities while absent?
Example: GA Coverage, Online Assignment
*
If you need a message posted on your office or classroom door, provide the room number and message text.
*