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Employee Leave Request Form

- Human Resources

This form is not accepting responses at this time.
- Employee Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parish/School (include city) REQUIRED Please fill out this field. Please enter valid data.
  
  Paylocity ID REQUIRED Please fill out this field. Please enter valid data.
  
  Department Please enter valid data.
  
  Job Title REQUIRED Please fill out this field. Please enter valid data.
  
  Employee ID Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Personal Email REQUIRED Please fill out this field. Please enter an email address.
- Type of Leave Requested
  
  Check all that apply & fill out the information below REQUIRED Maternity Leave Medical Leave Leave to care for a Family member Please fill out this field.
- Maternity Leave
  
  Due Date Please enter a date.
  
  Expected Return Date REQUIRED Please fill out this field. Please enter a date.
- Medical Leave
  
  Reason for leave: Please enter valid data.
  
  Start Date of Leave Please enter a date.
  
  Expected Return Date Please enter a date.
- Leave to care for a Family member
  
  Relationship Please enter valid data.
  
  Start Date of Leave Please enter a date.
  
  Expected Return Date Please enter a date.
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