REQUEST FOR TIME OFF/AWAY – FACULTY –

Department:  _____________________________
Name: _____________________________________
 

Conference Name or Continuing Education:
(These days will not be charged against vacation nor float time.  If you will not be completing an Authorization to Travel form, you must complete this section)
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

Conference/Continuing Education Date(s): ___________________________________________

Request for Vacation and Float Holiday

I request approval to take:

Vacation leave:                        Dates- ________________________________________

Float Holiday:                             Dates- _______________________________________

Other: ___________________     Dates- __________________________________

Total No. of days off:  _______________

Supervisor Approval:                                                                        (Faculty/Staff Signature and Date)

________________________________                                                               __________________________________
(Supervisor’s Name – Printed)                                                           (Supervisor’s Signature and Date)