Select your name from the drop-down list.
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/.
(include phone number)