1 Start 2 Complete Please use this form to request leave from our COVID-19 Shared Leave Bank. Leave donated through this program is to support university employees who are unable to work due to certain COVID-19-related reasons, who are receiving less than full paid leave, and who have exhausted all of their own personal leave balances. To be eligible to receive donated leave: You must be receiving less than full paid administrative or fully paid leave under the Families First Coronavirus Recovery Act (FFCRA) for one of the following reasons:You are not required to work on campus and you cannot telework because of the nature of your position; orYou are unable to work due to child care needs caused by a COVID-19 school or child care closing; orYou are unable to work due to elder care needs caused by a COVID-19 facility closure.You must have exhausted all forms of your own personal leave. If you meet these criteria and have either already exhausted your personal leave or you will not have enough leave to supplement your paid administrative or FFCRA leave for the current monthly pay period, you may request donated leave up to the amount necessary to provide you full pay for the pay period. New requests are required for each month beginning in July 2020 and through December 2020. All requests for donated leave must be made by the 15th of each month to allow donations to be processed in time for each monthly payroll. Our ability to provide you with any or all of the leave you request is dependent upon the amount of donated leave in the shared leave bank and the amount of leave requested by all employees. Available leave will be distributed equitably among all employees who submit requests each month. If you are provided with donated leave, you will be provided instructions for how to complete your timesheet or leave report. Personal Information First Name * Last Name * Banner ID * Email * Request Form Leave balances may be checked online through Employee Self-Service This submission is for the AUGUST 2020 payroll. Submissions are due by 5pm on 8/15/20. I meet the above criteria and have either already exhausted my personal leave or will not have enough leave to supplement my paid administrative or FFCRA leave for the current monthly pay period. * Yes No This criteria applies to me: * I am not required to work on campus and cannot telework because of the nature of my position. I am unable to work due to child care needs caused by a COVID-19 school or child care closing. I am unable to work due to elder care needs caused by a COVID-19 facility closure. How many hours of donated leave do you need to request for this payroll period? * hours STOP - you may not be eligible for donated leave. To be eligible to request shared leave, you must meet the above criteria and have either already exhausted my personal leave or will not have enough leave to supplement my paid administrative or FFCRA leave for the current monthly pay period. If you have questions about this policy, please contact the Office of Human Resources. Leave this field blank Submit
