Leave Request for Hourly (Non-Exempt) Employees

See instructions for questions about completing this form.

Employees must fill out all fields in the Personal Information and Dates/Hours section and include their supervisor and timekeeper's email address to submit leave. These fields are required.

PERSONAL INFORMATION
DATES/HOURS OF LEAVE

Recorded in 15 minute increments

LEAVE TYPE

or

*Other Leave: Disaster Leave-DIS, Donor Leave-DON, etc.

REASON
SUPERVISOR
DEPARTMENT TIMEKEEPER

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Signatures only required if printing request instead of submitting online.

KSU Policy and Procedures Manual Chapter:

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