麻豆国产

Lumpkin College Student Hub Absence Request Form

Please complete this form each time an absence from duty occurs.

Name Name First Last
Email
Absence due to:
Month of Requested Leave

Month of Requested Leave January February March April May June July August September October November December

Only one month per request form.
Date(s) of Requested Leave

Enter the day of the month (1, 2, 3, 4, etc).
Year of Requested Leave

Year of Requested Leave 2025 2026
Amount of Time Absent (hours)

Enter the number of hours you will be absent during normal work hours.
Working Through Lunch to Make Up Time (Same Day Only)

Working Through Lunch to Make Up Time (Same Day Only) Yes - I am working through lunch. No - I am not working through lunch.
Amount of Leave Used (hours)

Enter the number of hours you will use of leave.

If you are working through your lunch, this number will not match the Amount of Time Absent.
Type of Leave

Type of Leave Sick Leave Accrued Leave Personal Day (ASP only) Professional Development (if approved, no leave used)
Additional Information