APPENDIX E

   VILLAGE OF ORLAND HILLS PAID LEAVE OF ABSENCE FORM

Date:    

Employee:    

Department:   

Type of Leave (check one)                         Court Leave

                                        Bereavement Leave

                                        Military Reserve Leave

                                        Other              

Total Number of Days Taken (or to be taken):                          

Employee Signature:   

Supervisor Approval:   

Supervisor Denial:   

Copies:   Finance

      Department

      Employee

(Ord. 89-09, passed 4-12-89)