SFASU Human Resources

This form will be used in lieu of a PAR only for employees who have the available sick or vacation time accrued.

Any leaves without pay (LWOP) still require a PAR to be submitted.

Please make sure that all the information is filled out correctly.

Name of Employee Requesting Leave:

Employee's Campus ID#: Employee's Department:

CHECK ALL THAT APPLY:

Type of Leave: FMLA Parental or Foster Parent Leave Worker's Compensation

Military Training or Duty National Emergency or National Guard Duty

Start Date of Leave:

Anticipated End Date of Leave: if unknown, type "UNKNOWN"

Available Time: Vacation Sick

Additional Comments:

Contact Information:

Your Name: Your Department: Your Phone Number:

If you wish to have a printed copy of this screen -- click on the "Print me!" link at the bottom of the page before submitting the form.

A copy of the Return to Work Slip MUST BE SUMBITTED to HR -- Fax 7056.