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University of Louisville Human Resources Request for Leave

Employee Name: EmployeeID(emplid#):
Employee Title:
Employee Department:
Employee Email Address:
please enter the complete email address (ie user@louisville.edu)

Type of Leave Requested: (Choose One):

Explanation:

Total Number of Hours (Optional):


Date
(Month/Day/Year)
Time
Hour:Minute AM/PM)
Time and date leave to begin:
Time and date leave to end:

Please enter the EMAIL ADDRESS of your supervisor or the appropriate person for approval of your leave requests:

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