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REQUEST FOR VACATION / PERSONAL HOLIDAY / SICK LEAVE

Date:
Name:
Email Address:
Please consult the NU Staff Handbook, pages 18—33, for guidelines concerning use of vacation time, personal floating holidays, sick or other leave. The handbook is available from the NU Human Resources website at http://www.northwestern.edu/hr/handbook.pdf.
TYPE OF ABSENCE: VACATION PERSONAL HOLIDAY SICK/OTHER LEAVE
TYPE OF REQUEST: NEW UPDATE/CHANGE CANCEL
NOTE: Use UPDATE/CHANGE to make small adjustments to submitted requests;
otherwise, CANCEL the existing request and submit a NEW request.
START DATE:
(First day absent from work)
START TIME:
(If less than a full day)
END DATE:
(Last day absent from work)
END TIME:
(If less than a full day)
NOTES:
(List any special considerations; reason for sick or other leave; e.g. Medical Appt., Funeral, Jury Duty, etc.)

SUPERVISOR:
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Department of Chemistry  2145 Sheridan Road   Evanston, IL 60208-3113
Phone: (847) 491-5371  Fax: (847) 491-7713  Email: info@chem.northwestern.edu
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