Verification of Absence

1
It is required that you call out 2 hours prior to your shift starting.* This field is required.If you do not call out prior to 2 hours of your scheduled shift start time you will not be eligible for sick pay.
2
Excessive Absenteeism* This field is required.If you miss more than 1 day in a 30 day period it will result in a written warning.
3
YOU CAN NOT GET PAID VACATION TIME FOR CALLING OFF SICK.Please refer to the Employee Handbook to review our Sick Time Policy and Vacation Policy
I understand that if I do not have any sick time available I will not be able to get paid vacation time.
4
IF YOU ARE CALLING OFF WORK FOR ANY REASON YOU WILL NEED TO CALL LAURENT AT (714)936-6060.

YOU MUST CALL OUT 2 HOURS BEFORE YOUR SHIFT STARTS.

IF THERE IS NO ANSWER YOU MUST LEAVE A VOICEMAIL.

EXCESSIVE ABSENTEEISM WILL RESULT IN A WRITE WARNING AND POSSIBLE TERMINATION.
5
You will automatically be deducted any available sick time. If you do not have any sick time available then you will automatically be deducted any available vacation time.

If you do not have any paid leave to cover your absence, your wages will be DOCKED as appropriate to your absence.
6
Date you will be Absent* This field is required.Must be completed before your shift starts.
Date
Month
Day
Year
7
Full Name* This field is required.
First Name
Last Name
8
Location* This field is required.Where are you based?
Arizona
BNSF - LA
BNSF - Portland
Commerce
Inland Empire
Seattle, Washington
Long Beach
Oakland
So Cal MGMT
9
Scheduled Shift* This field is required.
Shift 1 (AM)
Shift 2 (PM)
Shift 3 (Graveyard)
10
Reason for Absence* This field is required.
Personal Illness
Transportation Issue
Family Emergency
Other
11
Comments:
12
Is this Covid-19 related?Proof must be provided.
YESNO
13
Are you requesting to be paid Sick Time?* This field is required.You are responsible for knowing how much Sick Time you have accrued. It is posted on your paycheck stub.
YESNO
14
MTW Email* This field is required.Please enter your MTW assigned email address.
example@mtwusa.com
15
Employee Signature* This field is required.By my signature below I verify the above absences to be true and correct.
Should be Empty: