Time Off Request Form

Time Off Request

Request a time off from work
This form is used for the full-time staff of the DFPA to document time off requests or for 10-month positions to report sick time in lieu of KRONOS.

This form is sent to April Browning and Mark Lococo.
Employee Name

First NameMiddle NameLast Name
E-mail
example@example.com
Contact Number

Area CodePhone Number
Start Date

MonthDayYear
End Date

MonthDayYear
Return to work on

MonthDayYear
Reason
Additional Comments
If this time is during the academic year, please articulate your plans for coverage, if necessary.
Should be Empty: