Faculty Absence Request

Select your name from the drop-down list.
Reason
Check all that apply
MM slash DD slash YYYY
MM slash DD slash YYYY

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)