UNIVERSITY OF THE VIRGIN ISLANDS
UNIVERSITY OF THE VIRGIN ISLANDS Application for Leave Name: ________________________________ Employee No.: _____________________ Department: ________________________________ Date: _____________________ __________________________________________________________________________________ Leave Policy LEAVE WITH PAY must be requested and approved in advance. When advance approval is not secured (illness, personal emergencies) your supervisor must be notified of the request for LEAVE WITH PAY within (1) hour after leave begins. If you are unable to reach your supervisor, notify the Personnel Office. If the University is not notified of the request for leave as provided for above, the time absent without notification must be charged to LEAVE WTHOUT PAY. …
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UNIVERSITY OF THE VIRGIN ISLANDS Application for Leave Name: ________________________________ Employee No.: _____________________ Department: ________________________________ Date: _____________________ __________________________________________________________________________________ Leave Policy LEAVE WITH PAY must be requested and approved in advance. When advance approval is not secured (illness, personal emergencies) your supervisor must be notified of the request for LEAVE WITH PAY within (1) hour after leave begins. If you are unable to reach your supervisor, notify the Personnel Office. If the University is not notified of the request for leave as provided for above, the time absent without notification must be charged to LEAVE WTHOUT PAY. This request is for: Leave with Pay Leave without Pay Date leave was requested: _____________________ Time: ________________ Person Contacted: ____________________________ Dept.:_______________________ Reason for Late or No notification:_____________________________________ Duration of Absence Charge Absence To Hours Date Time Hours Annual Leave From Sick Leave To Compensatory Leave From Leave Without Pay To Other Leave Description of Absence Vacation Personal Illness/Injury Lateness Personal Time Doctor/Dentist Visit Jury Duty Funeral-Non immediate Family Death-Immediate Family Suspension Family Illness/Injury Accident on Duty Other_______________ Other Particulars::__________________________________________________________________ Medical Certificate Attached for THREE (3) days or More Days of SICK LEAVE Vacation Pay Check requested by:________________________________ (Date) Certified:_______________________________________ Approved:_________________________ Employee Department Head PAYROLL NOTIFICATION (FOR PERSONNEL OFFICE USE ONLY) Process Vacation Paycheck for Period Ending ______________________Date Req._________ Adjust Employee’s Paycheck for ________Hours of LEAVE WITHOUT PAY Other___________________________________________________________________________ Approved: _______________________________________ Date:_______________________ Human Resources Manager