Staff Absence Request Form

Please note: Filling out this form does NOT take the place of informing your supervisor of your absence.

Employee Name *
Employee Name
First Date of Absence: *
First Date of Absence:
Last Date of Absence: *
Last Date of Absence:
How many Sundays does your absence span?
Type of Absence Requested *
You must submit a request for vacation one month prior to your dates of absence. You may call in sick the day of, but a form must be submitted upon your return to work. All other requests must be submitted two days prior to the first day you will be absent. Filling out this form does not take the place of notifying your supervisor that you will not be at work.