NHMA Staff Leave Request (SLR)
Welcome NHMA Team Member!

Submit your requested Paid Time Off (PTO) dates below.  Your request will then be reviewed by the Payroll Admin and by the Director.  You will then receive an email approval/rejection of your request. 
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Email *
First Name *
Last Name *
Phone Number *
Classroom *
Please select your assigned classroom
Number of Days Requested *
Leave begin date: *
MM
/
DD
/
YYYY
Return to work date: *
MM
/
DD
/
YYYY
Leave starting time *
Time
:
Leave end time *
Time
:
Type of leave *
Your Title
Clear selection
Additional information about your request
A copy of your responses will be emailed to the address you provided.
Submit
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