• Employee Military Leave Form

• 
  
• Date
• 
  
• Employee Last Name, First Name*
• Employee ID#*
• Department*
• Title/Position
• Supervisor*
• Supervisor Email
• Employee Address*

  Street Address 1

  Street Address 2

  City

  State/Province/Region

  Postal/Zip Code

  Country
• Employee Phone*

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• 
  

  • The employee must provide a copy of his/her military orders for the department personnel file.
  • Leave with pay must be approved by the leave administrators.
  • It is recommended for the employee to review life insurance and other important coverages.
• 
  
• Employee Rank*
• Employee Unit*
• Leave Period Begins*
• Leave Period Ends*
• 
  
• Employee Signature and Date*
• Administrator Signature and Date*