Employee Leave/Coverage Request Form

Employee Leave/Coverage Request Form
FIRST AND LAST NAME*
YOUR EMAIL ADDRESS*
example@example.com
TYPE OF LEAVE REQUESTED*

Sick/BereavementPersonalOther
DATE REQUESTED*

MonthDayYear
AMOUNT OF TIME REQUESTING*

FULL DAYHALF DAYOther
WHAT TIME WILL YOU BE LEAVING/ARRIVING?*
PROVIDE THE PERIODS YOU NEED COVERED (EVEN IF YOU ARE OUT ALL DAY!)*
*DO NOT PUT COVERAGE NEEDED FOR YOUR PREP OR LUNCH PERIODS*
PLEASE PROVIDE THE REASON FOR THE LEAVE/COVERAGE NEED *
*YOU MAY ENTER "PERSONAL" FOR PERSONAL TIME*
Should be Empty: