Dept. of Human Services Absence Notification Form - Civil Service
Dept. of Human Services Absence Notification Form - Civil Service
Name:
Name:
*
First
Last
Email:
*
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:
Sick Leave
Vacation
Court Required Leave
Bereavement Leave
Family Medical Leave (FMLA)
Which activities will you miss while absent?
(check all that apply)
*
Which activities will you miss while absent?
(check all that apply)
Office Hours
Departmental Meeting
List each missed activity, including the days/times and location.
Example: Office hours Wed 2-4 KH 2020
*