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UPC Staff Leave Request
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Name
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Today's Date
MM
/
DD
/
YYYY
Out of the Office
Vacation Leave
Sick Leave
Study Leave
Unpaid Leave
Other:
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Type of Request
Initial leave request
Change or correction to previously submitted request
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First Day Away
MM
/
DD
/
YYYY
Last Day Away
MM
/
DD
/
YYYY
How many hours will you be away?
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Comments/Explanation
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