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Absence
Request Form
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absence Report / request form
*
Indicates required field
Employee Name Requesting
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Date(s) Requested
*
Manager you report to
*
Have you reported absence to your manager?
*
Yes
No
Type of Request
*
Vacation
Absent
Tardy
Left Early
Additional Comments
*
Reason
*
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
Jury Duty
Military
Death in Family
Other - Please explain in additional comments
Submit
