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Leave Request
Requests MUST be submitted a minimum of 5 business days prior to the requested leave date.
Today's Date
*
/
Month
/
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Employee Name
*
First Name
Last Name
Suffix
E-mail
*
example@example.com
Contact Number
*
Format: (000) 000-0000.
Job Title
*
Please Select
Bus Driver
Attendant
Lot Personnel
Mechanic
Office Staff
How many days are you requesting off?
*
A SINGLE DAY
MULTIPLE CONSECUTIVE DAYS
Requested Day Off
*
/
Month
/
Day
Year
Date
How much of the selected date will you need off?
*
All Day
AM Run only
Mid-day Run only
PM Run only
Other
Multi Day Leave START Date:
*
/
Month
/
Day
Year
Date
Date you will return to work
*
/
Month
/
Day
Year
Date
Reason
*
Please Select
Vacation
Doctor Appointment
Bereavement
Other - state reason in additional comments
Is your Left/Right run sheet on file, in the main office?
*
YES
NO
N/A (for non-drivers only)
Additional Comments
Should be Empty: