STAFF ABSENCE REQUEST

STAFF ABSENCE REQUEST
Employee
Today's Date

MonthDayYear
Date
Employee Email
example@example.com
Supervisor
PLEASE CHOOSE THE TYPE OF REQUEST YOU ARE SUBMITTING
REQUEST TYPE
Must be submitted a minimum of 2 weeks prior to your absence.
TIME OFF REQUEST - REASON FOR ABSENCE
Please submit upon your return to work.
RETURNING TO WORK - REASON FOR ABSENCE
Conference First Date of Absence

MonthDayYear
Date
Conference Last Date of Absence

MonthDayYear
Date
Conference Total Days Used
Scheduled Church Activity First Date of Absence

MonthDayYear
Date
Scheduled Church Activity Last Date of Absence

MonthDayYear
Date
Scheduled Church Activity Total Days Used
Vacation First Date of Absence

MonthDayYear
Date
Vacation Last Date of Absence

MonthDayYear
Date
Vacation Total Days Used
Other First Date of Absence

MonthDayYear
Date
Other Last Date of Absence

MonthDayYear
Date
Other Total Days Used
Bereavement First Date of Absence

MonthDayYear
Date
Bereavment Last Date of Absence

MonthDayYear
Date
Bereavement Total Days Used
Personal Day First Date of Absence (2 per year)

MonthDayYear
Date
Personal Day Last Date of Absence (2 per year)

MonthDayYear
Date
Personal Day Total Days Used (2 per year)
Sick Leave First Date of Absence

MonthDayYear
Date
Sick Leave Last Date of Absence

MonthDayYear
Date
Sick Leave Total Days Used
Employee's Signature
Once your request receives final approval, a copy will be returned to you, one given to the business office and one kept on file with your supervisor.
Should be Empty: