Maternity Leave of Absence Request (IT Employee)
Submit your request for maternity leave as an IT department employee. Please complete all required sections for HR review.
Employee Full Name
*
First Name
Last Name
Employee ID Number
*
Department
*
Please Select
IT Support
Software Development
Network Administration
Cybersecurity
Other
Job Title
*
Work Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Manager/Supervisor Name
*
Planned Start Date of Leave
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Planned End Date of Leave
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Work Coverage Plan During Absence (briefly describe how your duties will be covered)
*
Emergency Contact Name and Phone Number
*
Additional Notes or Special Requests (optional)
Submit Leave Request
Should be Empty: