CLARENDON COLLEGE

EMPLOYEE ABSENTEE REPORT / REQUEST FOR LEAVE

____________________________________ ______________________________

Employee Name (Please Print) Social Security Number

[ ] I was absent from duties at Clarendon College on:

[ ] I will be absent from my duties at Clarendon College on:

Re: [ ] Sick Leave [ ] Personal Leave* [ ] Vacation^** [ ] Professional Leave⁺

Full Days (dates) _______________________________________________________________

Partial Days (dates and hours) ____________________________________________________

For the following reason(s): ______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

If applicable, how are classes to be covered? _________________________________________

______________________________________________________________________________

Employee Signature ______________________________ Date______________

Dept Head Signature ______________________________ Date______________

Approving Official ______________________________ Date______________

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^* A request for leave must be requested and approved in advance by the Supervisor and the Office of the President.

^** Full-time 12 Month (Non-Faculty) Employees Only

⁺ Please attach documentation involving conferences, meetings, etc.

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