Time Off Request Form
Name
*
Please Select
Adina Golombeck
Ahuva Brown
Aliza Breen
Aliza Coleman
Ana Roque
Avital Rubin
Bassie Shaw
Bayla Lebovits
Chana Perel
Chanie Koster
Chany Sigall
Chava Gittel Gewirtz
Chava Parnes
Chaya Gross
Chaya Nulman
Daniella Winegard
Dassie Nierman
Elissa Berkowitz
Emily Pared
Eunice Silverio
Goldee Benlolo
Hadassa Pam
Hannah Yaffe
Ivette Garcia
Katherine Almonte
Leah Langer
Libby Buxbaum
Maria Aquino
Malka Wachsman
Miriam Esral
Miriam Gowar
Naava Steinharter
Nechama Halpern
Mushkie Posner
Nicole Oved
Penina Golombeck
Peshie Goldberg
Raquel Lexier
Rechyl Sirota
Rena Wachsman
Riki Posner
Rivka Friedman
Rivka Hauser
Rochel Frank
Sara Rubin
Sarah Feldman
Sarah Klein
Sarah Salhov
Sarah Sentell
Shevy Hewitt
Shira Savir
Sorah Stoll
Tzippy Brenner
Email
*
example@example.com
Request Type
*
Schedule Change
Time Off
Location Change
When will you be making up the time?
*
Please include date, time & time zone
Please indicate your location, time zone, and work setup.
*
Supervisor
*
Please Select
Mrs. Tzippy Brenner
Ms. Ahuva Brown
Mrs. Aliza Coleman
Mrs. Rivka Friedman
Mrs. Miriam Gowar
Mrs. Rivka Leah Hauser
Mrs. Sarah Klein
Mrs. Dassie Nierman
Mrs. Nicole Oved
Mrs. Hadassah Pam
Mrs. Sarah Rubin
Mr. Yigal Sasportas
Department
*
Please Select
Admin
Business Office
Development Office
Human Resources Office
Tuitions Office
Onboarding
IT
Supervisor Email
*
example@example.com
Reason for {requestType}
*
Start Date (Time should be in CST)
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes in CST Minutes
AM
PM
AM/PM Option
End Date (Time should be in CST)
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes in CST Minutes
AM
PM
AM/PM Option
Please Approve or Deny the request
*
Please Select
Approve
Deny
Reason for denied request
*
Notes to the employee
Submit
Should be Empty: