FACULTY LEAVE REQUEST AND SUBSTITUTION FORM
Please remember, all leave must be approved, in advance, by your supervisor!
BEFORE filling out this form, go to MyCNM to get your leave balance(s) under the "Employee" tab.
First Name:
Employment Status:
Select One
FT
PT
Last Name:
School:
Select One
AT
BIT
CHSS
HWPS
MSE
SAGE
Employee ID#:
Example: How to Enter Missed Classes
Day(s)
M, T, W, R, F, S, U
Time
Course
Course #
Section #
Enter Substitute Name
or Class Cancelled
Hours Requested per Class
(each class must be rounded up to the nearest 0.5 hour)
Example 1
M
9:30am - 10:45am
AA
1102
101
Jane Doe
*1.5
Example 2
T / R
1:30 - 2:45pm
AA
1105
126
Jane Doe
*3.0
Enter Missed Classes:
1.
Select One
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
9.5
10.0
2.
Select One
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
9.5
10.0
3.
Select One
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
9.5
10.0
4.
Select One
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
9.5
10.0
5.
Select One
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
9.5
10.0
6.
Select One
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
9.5
10.0
7.
Select One
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
9.5
10.0
8.
Select One
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
9.5
10.0
OPTIONAL FLEX TIME:
An employee may use "flex time" for the rescheduling of office and/or other duty hours, provided the flexed hours do not conflict
with the employee's schedule. Flexed hours must be rescheduled within the subsequent six (6) days and be approved by the
employee's supervisor. Flextime does not require the use of accrued leave.
Currently Scheduled Office and/or Other Duty to Flex-enter dates and times:
Replacement Hours "flexed" to-enter dates and times:
LEAVE REQUEST SUMMARY:
TYPE OF LEAVE REQUESTED:
Select One
Personal
Sick
Bereavement
Leave- No Pay
Legal Leave
Professional Leave
Military Leave
Flex Time
PHL
FML
Leave Balance
If Requesting
Personal
or
Sick
Leave
ONLY
.
DATES OF REQUESTED LEAVE:
Start Date:
End Date:
mm/dd/yy
mm/dd/yy
Total
Class
Hours Absent:
Select One
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
9.5
10.0
10.5
11.0
11.5
12.0
12.5
13.0
13.5
14.0
14.5
15.0
15.5
16.0
16.5
17.0
17.5
18.0
18.5
19.0
19.5
20.0
20.5
21.0
21.5
22.0
22.5
23.0
23.5
24.0
24.5
25.0
25.5
26.0
26.5
27.0
27.5
28.0
28.5
29.0
29.5
30.0
Each
class must be rounded up to the nearest 0.5 hour
Total
Office
Hours Absent:
Select One
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
9.5
10.0
10.5
11.0
11.5
12.0
Each
class must be rounded up to the nearest 0.5 hour
Total
Other Duty
Hours Absent:
Select One
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
9.5
10.0
10.5
11.0
11.5
12.0
12.5
13.0
13.5
14.0
14.5
15.0
15.5
16.0
16.5
17.0
FT ONLY-
Each
other duty hour must be rounded up to the nearest 0.5 hour
TOTAL LEAVE REQUESTED
Total of all class, office, and other duty hours
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