FACULTY Time Off/Sick Time Form

FACULTY-Time Off/Sick Time Form

All Xavier faculty/teachers should use this form for time off/sick time
IMPORTANT:

The Business Office will receive your form upon submission.
Employee's Name *
Employee's Email *
example@example.com
First Date of Absence(s) *

Month Day Year
Date
Time Leaving(if a partial day)

: Hour Minutes AM/PM Option
Time Returning(if a partial day)

: Hour Minutes AM/PM Option
Last Date of Absence(s) (only if more than one day)

Month Day Year
Date
Total Days of Absence(s) *
# of days, ex: 1, 2 , 3 etc.
For the classes/periods that you will need coverage, will you be on Zoom with your class?

Yes No
Supervisor's Name *

First Name Last Name
Supervisor's Email (Supervisor will get an email with this information to send to Business Office with their approval) *
example@example.com
Reason for Time Off/Sick Time

Please select the Non Xavier related reason OR Xavier related reason (which section applies to your request)
Non Xavier related reason (please select that apply)

Vacation Personal (i.e. wedding, funeral, etc.) Sick Time (self) return within 24 hours of absence Sick Time (family) return within 24 hours of absence Jury Duty (unpaid) Off Campus Appointment
Xavier related reason (please check below)

Conference/Colloquium Athletics Retreat/Immersion Club/CLC Off Campus Appointment
Are you FACULTY?

YES (Click YES and upload a document of your sub plans for each day absent) NO
Click on the link below to access the online Sub Plans Form to be completed and then uploaded below.

Online Sub Plans Form
Upload your sub plans here. *

Browse Files

Cancel of
Xavier College Prep *
Should be Empty:

FACULTY-Time Off/Sick Time Form

Reason for Time Off/Sick Time