CTHS Request for Leave
Please submit the times you need to take off work and the type of leave you are taking.
Email address *
Campus *
Name *
Your answer
Days Requested *
Your answer
All Day *
Type of Leave *
Description if needed.
Reason for Leave *
Your answer
Are you traveling and seeking reimbursement? *
Miles at $.31 per mile and total *
Your answer
Registration Fee: *
Your answer
Air, rail, or taxi travel cost (list name and cost ex: Taxi $50, Air $500) *
Your answer
Hotel Cost *
Your answer
Meals and incidentals costs *
Your answer
Tolls, Parking, Baggage Fees. (List fees with description) *
Your answer
Total reimbursement cost seeking: *
Your answer
Time Remaining (Please do not fill this section out)
A copy of your responses will be emailed to the address you provided.
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