Last Minute Absence Notification
DO NOT USE THIS FORM TO REQUEST FUTURE TIME OFF
Use this form if you will miss your next scheduled shift. Please submit as soon as known, ideally at least (1) hour before the start of the shift. Do not text, call, or email management. Excused and Unexcused Absences as outlined in the Attendance Policy will apply. Accrued paid sick leave will be applied toward absences due to illness.
Name
*
First Name
Last Name
E-mail
*
example@example.com
Type of Absence
*
Illness or Injury
Adverse weather conditions resulting in the closing of schools or roads.
Automobile accident, or car trouble.
Other - Excused and Unexcused Absences as outlined in the Attendance Policy will apply.
Duration
*
Full Shift
Late Arrival
First Date of Missed Work
*
-
Month
-
Day
Year
Date
If Late Arrival - Enter Arrival Time. You will need to complete another notification if you will not make this time.
Hour Minutes
AM
PM
AM/PM Option
Anticipated Return to Work Date. (If unknown, list next scheduled work date and return to complete form again if more time needed.)
*
-
Month
-
Day
Year
Date
Please describe the reason for your absence, and indicate anticipated arrival/departure time:
*
Submit
Should be Empty: