PTO form

Employee name

E-mail address @lakeviewcol.edu

Supervisor

Date(s)

PTO (staff only)

Mental Health (staff only) (refer to policy)

EIB (staff only) (refer to policy)

Personal business (faculty only)

Sick days (faculty only)

Bereavement (refer to policy)

Jury duty - email copy of summons (refer to policy)

Leave of absence without pay (refer to policy)

Flex time leave (salary staff only - 4 hours per day max)

Overtime (hourly staff only) (must be pre-approved by President)

Notes

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