Time Off Request Form – Faculty of Arts and Sciences

This form is for FASC staff use only. Please be sure to include your supervisor’s correct email address to ensure your request reaches our office. If you have any questions please contact Assistant Dean Julie Roncinske. Please note: emergency sick time can also be requested directly through your supervisor who can notify Julie Roncinske to input your sick time in HR’s app.

"*" indicates required fields

Employee Information

Name*

First Last

Email*

Supervisor(s) Information

Please include the email of your main supervisor to notify for approval. If you have more than one person you report to, you have the option to include them in this request and they will receive a copy of your request. Only your main supervisor needs to approve this request.

Main Supervisor's Email*

Supervisor 2 Email (optional)

Supervisor 3 Email (optional)

Dates and Type of Request

You can request more than one set of dates. See below for instructions.

Type of Day(s) and Absence Reporting System ARS code(s)*

Please list below the day(s) you are requesting and hours requested (i.e. full day, half day, 2 hours, etc...), type of time off request, and what ARS code to use for each day. Types of time off requests are: Vacation, Sick Time, NJ Earned Sick Leave, Personal Leave, Comp time, Jury Duty, Family and Medical Leave, Bereavement Leave, Other. Type of code to be used in ARS include: V- Vacation, S - Sick Time, NJESL - NJ Earned Sick Leave, AL - Administrative Leave, PH - Personal Holiday, C - Comp Time.

Additional Information

Optional. Include if applicable. Examples include: I have a doctor's note, jury notice, etc...

Please upload any doctors notes, jury duty notices, or supplemental information, if applicable.

Max. file size: 7 MB.

Complete this equation: 4+5=*

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Phone

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