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Sick Leave Pool Request Packet - Stephen F. Austin State University 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the date at the top of the form. This is essential for tracking your request.
- Fill in your Social Security Number, name, address, department, and title accurately to ensure proper identification.
- Indicate your last day worked and provide a detailed description of the circumstances that qualify you for sick leave pool assistance. Remember to attach any necessary medical certification from a licensed practitioner.
- Sign the form where indicated to confirm your request. Ensure all information is complete before submission.
- If applicable, have your licensed practitioner complete their section, including their signature and contact information.
- Finally, submit the completed form to Human Resources as instructed at the bottom of the document.
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Related links
Please describe the circumstances, which you believe qualify you to receive sick leave from the sick leave pool (attach additional pages as needed).Read more
(Request Permission) Unless otherwise indicated, all materials in this PDF are copyrighted by the National Academy of Sciences. Copyright National Academy ofRead more