Request for Unpaid Leave. The employee must submit such request and the reasons for the leave, in writing, to the Town Supervisor as soon as reasonably possible prior to planned commencement of the requested leave. The Town Board has sole discretion in approving such leave.
Request for Unpaid Leave. The employee must submit such request and the reasons for the leave, in writing, to the Mayor at least thirty calendar days prior to planned commencement of the requested leave. The Mayor has sole discretion in approving such leave.
Request for Unpaid Leave. The employee must submit such request and the reasons for the leave, in writing, to the Chief of Police at least thirty calendar days prior to planned commencement of the requested leave. The Town Board has sole discretion in approving such leave.
Request for Unpaid Leave. To be eligible for an unpaid leave, the Association member must submit a written request to both their immediate supervisor and the appropriate Vice President, one month in advance of the requested leave date. The request for leave will state the specific reason for the leave, the beginning date and the return to work date. The College may require an employee to utilize accrued vacation/personal time prior to approval of an unpaid leave.
Request for Unpaid Leave. Employee: Job Classification: Job Site: I hereby request day(s) or hour(s) of unpaid leave from to on (Time) (Time) (Date) Unpaid Leave being requested: Sick Leave Association Leave Parental Leave Military Leave Court Leave Disability Leave Family Medical Leave Unpaid Emergency Leave (no more than 3 hours) Other Reason for Request: ADMINISTRATIVE USE ONLY Recommended Not Recommended Supervisor Approve (if required) Disapprove Superintendent Approve (if required) Disapprove Employee Signature Request Date Date Received Appendix D COLUMBIANA COUNTY BOARD OF DEVELOPMENTAL DISABLILITIES HEALTH/SAFETY HAZARD REPORT FORM Facility: Area or Equipment: Reporting employee Person who received this report Date Submitted Concise statement of immediate health/safety concern: Signature Supervisor’s Response: Signature Date Returned Appendix E COLUMBIANA COUNTY BOARD OF DEVELOPMENTAL DISABILITIES DAMAGE TO EMPLOYEE’S PROPERTY REPORT FORM Employee: Job Classification: Work Site: Date: Supervisor: Incident leading to damage of property (be specific): List damaged property: Employee’s Signature Date Supervisor’s Signature Date Within 10 days, the employee must submit a cost estimate for replacement of damaged goods. No further action will be taken until estimates are submitted. Appendix F COLUMBIANA COUNTY BOARD OF DEVELOPMENTAL DISABILITIES
Request for Unpaid Leave. 1. Written application to be submitted by the employee to the Superintendent at least two
Request for Unpaid Leave. 1. Written application to be submitted by the employee to the Superintendent at least two (2) weeks in advance of need for purposes specified in this article only.
Request for Unpaid Leave. Those employees desiring an unpaid leave ofabsence shall make a written request at least six (6) weeks in advance, if possible, of the administration stating the reason for the leave, begin date and end date. Extenuating circumstances will be handled individually. Request forms are available from the employee's immediate supervisor or Human Resources. All available leave time must be exhausted when applying for unpaid leave. All leave of absence requests require the approval of the employee's immediate supervisor and Human Resources. Xxxxxx Public Schools will comply with the provisions of the Family Medical Leave Act (FMLA).
Request for Unpaid Leave. The Employee has requested the following dates (week) (month) (semester) (up to one year) of educational leave without pay or benefits from his/her duties at A-B Tech in order to pursue activities as approved in the College’s policy and procedures manual related to Educational Leave. DATES:_______________________________________________________________________ The Employee agrees to abide by the standards listed in the procedure attached to this request, and have initialed a copy to be placed in the personnel file. Nothing in this Agreement is intended or shall be construed to constitute a contract of employment between A-B Tech and the Employee. Agreed: Employee Date Vice President Date
Request for Unpaid Leave. Day(s): (It is specifically understood that the above requested leave day(s) is(are) without pay at the request of the employee) □ Annual Breast/Prostate Cancer Screening: up to 4 hours; non-chargeable leave (verification to be provided to the District) I hereby certify that this matter cannot be handled except during regular working hours. Signature - Employee Date Signed INSTRUCTIONS Respecting the above stated reasons, no additional explanations are required to establish entitlement, except as specifically indicated above. Check the applicable reason and, if required, furnish the additional information requested. REVIEWED BY ADMINISTRATOR
