Shared Leave Donation Form

Donation Form

Employee Name(Required)

First Last

Employee ID Number(Required)

Department(Required)

Boise State Email(Required)

Phone Extension Number(Required)

Supervisor Name(Required)

First Last

No employee may make a transfer of vacation/sick leave that would reduce his or her accrual balance below 80 hours. Cannot exceed eighty (80) hours in a fiscal year and must be in minimum increments of four (4) hours.

Select which type of leave you wish to transfer from(Required)

Vacation

Sick

How many hours of vacation/sick leave would you like to transfer?(Required)

Name of Boise State Employee to receive your transferred hours of vacation leave

*If you would like to make the donation to anyone in need, check the box below and leave the Name field blank

First Last

If you would like to make a general donation for anyone in need please check here and leave recipient name blank

Please donate to anyone in need

Signature(Required)

Date

YYYY

Shared Leave Donation Form

Donation Form

Human Resource Services