The Gail & Richard Lumpkin School of Nursing - Absence Request

The Gail & Richard Lumpkin School of Nursing - Absence Request

I am requesting use of the following benefit time/time-off privilege:

The Chair or Supervisor will approve by emaling approval.

Name Name * First Last
Today's Date Today's Date * / MM / DD YYYY
Type of Leave *
Beginning Date Beginning Date * / MM / DD YYYY
Ending Date Ending Date / MM / DD YYYY
Total Hours Used *
AM, PM, or All Day *
Comments
Name *
Your EIU Email *