OLD FORM

 

REQUEST TO DONATE SHARED LEAVE

WASHINGTON STATE SCHOOL FOR THE BLIND

 

(Please Print)

 

I, _____________________________________, request to donate _____________ hours

            (Name of Donor)                                                                   (# of hrs.)

 

Annual/sick/personal holiday leave to _______________________________________ at

(Circle one)                                                    (Name of Recipient)

 

__________________________________.

            (Agency)

 

This donation will not cause my annual leave balance to fall below 80 hours.

 

This donation will not cause my sick leave balance to fall below 176 hours after the transfer.

 

This donation may be all or part of the donating employee’s personal holiday.

 

I have read and understand the donor information listed on the back of this form.  This shared leave is given voluntarily.

 

 

_______________________________________                  ________________________

Donating Employee’s Signature                                          Date

 

This request should be sent directly to the Human Resources Office.

 

 

_______ Approved                                         ______Disapproved

 

 

__________________________________________            ________________________

Signature of HR Manager                                                    Date

 

ELIGIBILITY TO DONATE SHARED LEAVE:

 

To donate shared leave the following conditions must apply:

 

1.                  The donating employee may donate any amount of vacation leave provided the donation does not cause the employees vacation leave balance to fall below 80 hours.

 

2.                  Employees may not donate excess vacation leave that the donor would not be able to take due to an approaching anniversary date.

 

3.                  The donating employee may donate any specified amount of sick leave provided the donation does not cause the employees sick leave balance to fall below 176 hours after the transfer.

 

4.                  The donating employee may donate all or part of their personal holiday.  Any portion of a personal holiday not used will be returned to the donating employee.

5.                  All donated leave must be given voluntarily.  No employee shall be coerced, threatened, intimidated or financially induced into donating leave for the purposes of this program.

 

6.                  Any shared leave not used by the recipient during this occurrence will be returned to the donors.

 

7.                  Approval authority for the purposes of this program is delegated to the Human Resources Manager of the Washington State School for the Blind.

 

To donate shared leave.

 

1.                  Fully complete the front of this form.

 

2.                  Submit form to the Human Resource Office.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NEW FORM

 

WSSB REQUEST TO DONATE SHARED LEAVE

 

 

Name of Donor:                                                                                                                                 

 

Name of Recipient/Agency:                                                                                                              

 

Number of Hours:                              

 

Circle Type of Leave:             Annual            Sick            Personal Holiday

 

To donate shared leave:

 

1.      Donation must not cause the employees vacation balance to fall below 80 hours; or sick leave balance to fall below 176 hours. 

2.      Submit completed form to the Human Resource office.

 

 

 

_______________________________________                  ________________________

Donor’s Signature                                                                 Date

 

 

For office use only

 

 

_______ Approved                                         ______Disapproved

 

 

 

__________________________________________            ________________________

HR Manager Signature                                                        Date

 

 

 

 

 

 

 

 

 

Processed by:                                                                           Date: