Request for Leave of Absence and Advance Degree Leave Name of Employee: _________________________ Social Security No.
________________________________________ Signature of Applicant Prior Leave Record From this Institution (To be certified by the institution): Date of Last Leave: _____________________ Length of Last Leave: _____________________ Type of Last Leave: With Pay __________ Amount $ ___________ Without Pay ____________ Type of Leave Recommended by Supervisor (Check One) a.
Without Pay ______ Page 1 of 2 Delgado Community College LCTCS Form - Request for Leave of Absence and Advanced Degree Leave Page 2 Approvals: Note: Employee is responsible for submitting a signed Recommendation Letter from his/her Department ...
Allowed
Microsoft Office Word (.doc, .dot) - application/msword
LCTCS Form for Delgado Employees - AdvDegree.LWOP.App06.15.04.doc