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YOUR CART
Absence
Request & Reporting
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absence request & Report Form
*
Indicates required field
Employee Name Requesting
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Date(s) Requested
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Approving Manager
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Type of Request
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Vacation
Absent
Tardy
Left Early
Excused
*
Yes
No
Reason
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Vacation - Use Vacation Time
Personal - Unpaid
Medical Appointment - Specify hours to be gone in comments
Sick - Use Sick Time if available
Sick - Do not use sick time
Leave of Absence
FMLA
Jury Duty
Military
Death in Family
Discipline
Other - Please explain in additional comments
Additional Comments
*
Submit
