Request for Leave of Absence Without Pay (LOAWP): Fill out & sign online

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Click ‘Get Form’ to open the Request for Leave of Absence Without Pay (LOAWP) in our editor.
Begin by filling out the Employee Information section. Enter your full name, employee ID, home address, job title/department, and contact numbers.
In the Absence Information section, specify your requested start date and anticipated return date. Note that you can only request a maximum of six weeks within a twelve-month period.
Select the reason for your leave from the provided options: employee illness, education, family illness, or personal reasons. If applicable, remember to attach any required medical certification.
Indicate any paid leave you wish to utilize by filling in the type and number of hours for sick leave or vacation. Specify the dates for each leave type.
After completing all sections, review your entries for accuracy before signing and dating the form. If necessary, seek supervisor approval based on your leave type.

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