Request Parental Leave for Graduate Assistants

Before completing this form, please review the full Parental Leave for Graduate Assistants university policy.

This form is used by eligible Graduate Assistants who would like to request a parental leave of absence due to a birth or adoption of a child. Parental Leave must be requested at least 60 days prior to the child's anticipated due date/adoption date, absent any unforeseeable circumstances.

GA Information

First Name

Last Name

Email Address

Boise State ID Number

What department or unit do you work for?

What is your GA Title?

Supervisor Information

Supervisor's First Name

Supervisor's Last Name

Supervisor's Email Address

Leave Information

Estimated Date of Birth, Adoption, or Placement of Child

Requested Begin Date of Parental Leave

Request Parental Leave for Graduate Assistants

Boise State University