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Vacation/Leave Request
Please submit the times you need to take off work and the type of leave you are taking.
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Name
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Your answer
Dates of Leave
*
Your answer
Type of leave
*
Vacation
Sick leave (Illness or Injury)
Bereavement leave (Immediate Family)
Bereavement leave (Other)
Jury duty or legal leave
Emergency leave
Temporary leave
Leave without pay
Other:
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