USC FULL-TIME ABSENCE REQUEST

Your Name Your Name First Last
Your Work Email
Dept. Manager
Current Date Current Date / MM / DD YYYY
Start Date of Leave Start Date of Leave / MM / DD YYYY
End Date of Leave End Date of Leave / MM / DD YYYY
Start Time Start Time : HH MM AM/PM
End Time End Time : HH MM AM/PM
Type of Leave
Any Additional Information or Comments
Manager Approval:

**Your manager must approve your absence request. Your manager will submit a copy to you and HR once the request has been approved.**
Your manager must approve your absence request. Your manager will submit a copy to you and HR once the request has been approved.