BMC Faculty Absence Reporting Form


Your Name:**

Your Email:*


Date Leaving:


Date Returning:


Total number of days counted as vacation:

Total number of days counted as Outside activity related to university duties (e.g., consulting):

Please fill in the specific location you can be reached while you are away including 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 click here to update your Outside Activities Report

Specific location (including numbers):

Select who will be assuming your duties while you are away:

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