Sick Leave & Absence Form : Department of Communication Studies : Texas State University

Instructor: *

Date of Absence: *

Format mm/dd/yyyy

Classes or Events Being Missed: *

Please Select One: *

Class is being cancelled

This should be used for emergencies or sudden illness

Class is being taught by a guest instructor or another faculty member

Class is being given an independent assignment

No Class is Being Missed

If for an event or other departmentally sanctioned activity

Reason for your Absence: *

Employee or Family Sick Leave

Medical Appointment

Dentist, Doctor, Therapy, etc...

Childs Educational activity

Funeral

Observing Religious Holiday

Jury Duty

Research

Prior approval from Marian Houser needed

Recruitment

Prior approval from Marian Houser needed

Other:

Please use the box below to explain. Subject to approval.

Please add any additional details: