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
MM slash DD slash YYYY