Request for Leave

Use this form to request vacation, sick or comp time.

Name Name * First Last
Email
UTA ID *
Have you discussed this request with your immediate supervisor? *

Have you discussed this request with your immediate supervisor? Yes No
Date Discussed Date Discussed / MM / DD YYYY
Supervisor's Name *
Type of Leave *

Type of Leave Vacation Sick Comp Vacation + Comp
Leave Start Date Leave Start Date * / MM / DD YYYY
Leave End Date Leave End Date / MM / DD YYYY
Total Number of Hours Requested *
If comp time, when was your comp time earned?