Time Off Request Form

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Time Off Request Form

*Time off requests are due PRIOR to the completion of monthly schedules.
Extended periods or continuous requests can result in change in employment status
(ex: full time to part time)

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* Indicates required question

Email *

Your email

Employee Name *

Your answer

What date(s) are you requesting off? *

Your answer

Reason for request *

Your answer

A copy of your responses will be emailed to the address you provided.

Submit

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