Faculty Sick Leave Record
                                                                                  For the Month of:_________________
 

 
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Sick Leave                                
 
 
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Total Days
Sick Leave                                

  Faculty Member's Certification: I certify that the entries on this record accurately and completely reflect my service to John Jay College during the stated period.

_____________________________                __________________________               ________________
          Name (please print)                                            Signature                                            Date

Department Chair's Certification: I certify that the employee was in full attendance in accordance with the administrative calendar, except as noted above.

_____________________________                __________________________               ________________
         Name (please print)                                            Signature                                            Date

Note: (Cards must be forwarded to the Human Resources Office by the 10th day of the following month)