Faculty Absence Request

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Your Name*

Select your name from the drop-down list.

Your Email Address*

Reason

Check all that apply

Vacation

Professional Activity

Outside Activity

Departure Date*

Return Date*

Number of Days Counted as Vacation*

Number of Days Counted as Outside Activity Related to University Duties*

Please fill in the specific location where you can be reached while you are away, including a phone number. Please give this form to the department Chair at least 10 working days prior to your anticipated absence. The Chair will respond within 5 days if the absence is not approved. If this absence impacts your outside activity, please update your Outside Activities Report at https://oar.wisc.edu/.

Specific Location*

(include phone number)

Who will assume your duties while you are away?*