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Requesting Time Off is NOT a Guarantee Your Time Will Be Approved.
9
Questions
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1
Name
*
This field is required.
First Name
Last Name
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2
Enter the First Day You Need Off.
*
This field is required.
-
Date
Year
Month
Day
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3
Enter the Day You Will Return
*
This field is required.
-
Date
Year
Month
Day
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4
Days or Shifts
Is this for ONE FULL DAY or MORE
YES
NO
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5
Time
For Hourly Shifts only. Enter the shift start time. If this is for the entire day leave blank.
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Hour
00
10
20
30
40
50
00
10
20
30
40
50
Minutes
AM
PM
PM
AM
PM
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6
Clients Name
*
This field is required.
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7
Shifts
*
This field is required.
Is this less than One Full Day?
YES
NO
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8
Shifts
IF LESS THAN A FULL DAY NAME CLIENT SHIFTS
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9
Please verify that you are human
*
This field is required.
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