Wufoo
Leave of Absence Request
Use this form to request a leave of absence and to notify the Executive Committee when you are returning from leave. Please note that even though your leave may be approved, you must still contact the SVRS secretary and/or president prior to each general meeting in order to be excused from that meeting (LOA does not automatically guarantee being excused from a meeting).
Name
*
Email
Leave of Absence Request
Submit your request for leave of absence here.
Requested Start Date
MM
/
DD
/
YYYY
Requested End Date
MM
/
DD
/
YYYY
Reason for Leave
Medical
Job/School
Family
Other (explain in comments)
Comments
Return from Leave of Absence
Please complete this section when returning from leave of absence.
Actual Return Date
MM
/
DD
/
YYYY
Comments
Do Not Fill This Out
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