REQUEST FOR VACATION DAYS
TODAYS DATE
*
-
Month
-
Day
Year
Date
STORE:
*
MI-75 ADRIAN
MI-79 BELLEVILLE
MI-86 BROWNSTOWN
MI-91 OAK VALLEY
MI-119 JACKSON
MI-128 YPSILANTI
MI-166 TECUMSEH
TN-13 HENDERS.
TN-15 FARRAGUT
TN-28 E. NASHVILLE
OFFICE STAFF
Name
*
First Name
Last Name
# OF DAYS REQUESTING
*
1
2
3
4
5
6
7
8
9
10
DATES REQUESTING OFF
*
-
Month
-
Day
Year
Date
THRU (IF MORE THAN ONE)
-
Month
-
Day
Year
Date
Comments
OFFICE USE ONLY
Approved/Denied by JC:
Approved
Denied
Reason:
Submit
Should be Empty: