ࡱ>  Jbjbj>!>! Cw\K?k\K?k U( ( !!!!!5558m5E!k"X#E%E%E%E%E%E%EvH,Kx%E]!""""%E!!E$$$"F!!#E$"#E$$R@B #vAEE0E#AK#K<BB&K!C""$"""""%E%EI$"""E""""K"""""""""( : Application for Leave for Public Duties/ Service in the Reserve Forces Please discuss your leave request with your line manager/supervisor and refer to the HYPERLINK "/human-resources/leave/special-leave/"Special Leave Policy before completing this form. Please send the completed form to the HYPERLINK "/human-resources/operational-services/ask-staff-hub/"Staff Hub, retaining a copy for your own records. Prior to submitting application, please liaise with the HYPERLINK "https://www.imperial.ac.uk/human-resources/operational-services/ask-staff-hub/"Staff Hub to clarify the impact of your leave (if approved) on your pension. Section 1: To be completed by ApplicantCID:  FORMTEXT      Title:  FORMTEXT      Surname:  FORMTEXT      First Name(s):  FORMTEXT      Dept/Div/Sch/Inst:  FORMTEXT      Section/Group:  FORMTEXT       Section B: Leave RequestI wish to apply for the following category of Special Leave:Leave for Public Duties FORMCHECKBOX Leave for Service in the Reserve Forces* *If request relates to notification of mobilisation for full-time service with the Regular Forces, please contact the Staff Hub as soon as possible FORMCHECKBOX  Additional details (specify dates requested, duration and reason for request) FORMTEXT       Details of leave being requestedDate leave to start: FORMTEXT      Date leave to end: FORMTEXT      Total no. of days requested: FORMTEXT      Total no. of days to be unpaid:* *Please note, if a period of approved Special Leave is wholly or partly unpaid, this will result in a deduction to your salary. 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