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Employee Leave Request
First Name:
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Last Name:
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Employee ID:
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(no dashes)
Classification:
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Classified
Academic/Unclassified
Email:
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Supervisor:
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Aguilar, Ashley
Angima, Sam
Annala, Dani
Applebee, Roxie
Arbogast, Jill
Ashton, Carolyn
Auyong, Jan
Baxter, Dana
Belden, Darlene
Black, Lynette
Boggess, William
Bondi, Michael
Bower, Shirley
Bowman, Sally
Brandt, Jeanne
Brandt, Stephen
Braunworth, Bill
Braverman, Marc
Breen III, Jack
Broadus, Marita
Brummer, Fara
Bubl, Chip
Burris, Frank
Burroughs, Debbie
Butler, Marvin
Carr, Renee
Castagnoli, Steve
Chamberlain, Anna-Marie
Chavez, Jenny
Ciuffetti, Lynda
Coakley, Stella
Collinger, Sandra
Corcoran, Patrick
Corp, Mary
Curtis, Larry
Curtis, Shelley
Deboodt, Tim
Delaney, Gary
DelCurto, Timothy
Derby, Amy (Davis)
Dickson, Marcia
Dodge-Vera, Tina
Downing, Troy
Draper, Georgia
Edge, Dan
Elmshaeuser, Scott
Etherington, Elizabeth
Fausett, Lowell
Fein, Lauren
Fitch, Jamie
Fitzgerald, Stephen
Fletcher, Rick
Freeman, Carlea
Galloway, Robin
Godwin, Derek
Gregg, Janice
Hamm, Phil
Hansen, David
Hart, Doug
Hartley, Betsy
Hatcher, Shevon
Hermes, James
Herring, Peg
Houglum, Lyla
Hoynacki, Dan
Hughes, Shelley
Hyde, Glenda
Ivey, Carol
Jepson, Paul
Johnson, Dustin
Johnson, Jim
Jones, Joy
Karow, Russ
Kellar, Jayne
Kershaw, Nancy
Killefer, John
King, Dave
Kiyokawa, Joanne
Kizer, Kjer
Knutz, Mike
Krenz, Vicki
Landgren, Chal
Lee, Janey
Livesay, Maggie
Long, Lynn
Lutcher, Larry
Macnab, Sandy
Macy, Danita
Maddy, Deborah
Maille, Robin
Maley, Jordan
Martin, Dana
Mayjor, Bryan
McCullough, Kim
McDonald, Sheryl
McGrath, Dan
McKibbin, Lisa
McMahan, Linda
Michaels, Laurie
Mills, Randy
Morrissey, Michael
Olsen, Liz
Osterlund, Cindy
Parker, Robert
Parsons, Cory
Peters, Amy
Petrie, Steven
Phelps, Lyn
Proden, Patrick
Punches, John
Quinn, Maureen
Reeb, Jim
Reed, Scott
Rennekamp, Roger
Riggs, Willie
Roemer, Bonnie
Roll, Nina
Rose, Pamela
Rose, Ian
Roseboro, Donita
Rowe, Shawn
Rudolph, Jenny
Russell, Jackie
Russell, Stephanie
Schreder, Peter
Schreiber, Deb
Seavert, Clark
Silberstein, Tom
Smiley, Janice
Smith, Carole
Steele, Lynn
Teraberry, Annette
Tobey, Lauren
Tuck, Brian
Turpin, Lucas
VanBuskirk, Philip
Vaughn, Margie
Webb, Elizabeth
Webmaster, Extension
Weidman, Rosemary
Wells, Elissa
Wiederholt, Pam
Williams, John
Wimer, Susan
Withee, Shana
Zaveson, Deb
Starting Date of Leave Request:
*
Month
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Year
2011
2012
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Starting Time:
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hour
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Ending Date of Leave Request:
*
Month
Jan
Feb
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Apr
May
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Dec
Day
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Year
2011
2012
2013
2014
2015
Ending Time:
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hour
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minute
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Total Number of Leave Hours Requested:
*
Reason for Leave (check all that apply):
*
Personal Business
Vacation
Sick (Self, care for family member)
FMLA
Military Leave
Jury Duty
Comp Time
Leave With Pay (Jury duty, military leave, bereavement leave, special day)
Leave Without Pay
Furloughs
Other
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