This form is designed for employees who wish to request leave under the Catastrophic Leave Program in response to a natural disaster or state of emergency. The program allows eligible employees to take a personal leave of absence with accrued leave credits and receive donated leave credits to cover extended absences caused by the catastrophic events.

The form includes fields to:

• Specify the requested start and end dates of the leave.
• Confirm eligibility and provide necessary supporting details about the natural disaster or emergency.
• Certify compliance with program requirements prior to the Catastrophic Leave donation eligibility.

*Note: Unit 3 employees are eligible for 10 days of emergency paid leave prior to using accrued leave credits and receipt of catastrophic leave donation credits. (Article 23.19)

This form simplifies the request process, ensuring compliance with CSU policies while providing much-needed support during challenging times.

For additional assistance, please contact the Leaves Office or visit the Disaster Relief Resources website for more information.