Faculty Leave without Pay Form

Faculty Leave without Pay Form

Please copy and paste the following form into Word. Then fill it out and print it off.

Indiana University Kokomo Paid Family Leave Application

Indiana University Kokomo Leave without Pay Application for Academic Appointees

To read the policy on Leaves without Pay:  https://policies.iu.edu/policies/aca-48-leave-without-pay-academic-appointees/index.html

Name:_____________________________________

Department:________________________________   

University ID:_______________________________                                       

Requesting unpaid leave of absence for the period

__________________________to ____________________________

For the following reasons:

(Write here, or attach separate sheet)