Administrator and Faculty Request to Receive Donated Leave

This form is used by administrative and faculty employees that are benefits eligible to request donated time from the paid leave pool. Employees may request a maximum of 160 hours or 20 days. Requested time must be used for the illness or injury of the employee or a family member. Certification from the physician is required. 

To submit your form:

1. Locate the form in the Attachments section.

2. Complete all required fields.

3. Once finished, click the Upload Form button and attach your completed document.