AFSCME 3200 Request to Receive Donated Sick Leave

This form is used by employees of the AFSCME 3200 bargaining unit to request donated sick time. Employees may request a maximum of 160 hours or 20 days. The employee must have a current active physician certification (FMLA #.04 or FMLA #.05) on file with University Human Resources prior to this form being processed.