REQUEST FOR TIME OFF
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Employee Name: *
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Building Location: *
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Date(s) of Absence: *
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Day(s) of the Week: *
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Half Day, Full Day, Other: *
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If Other, please clarify:
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Type of Leave Requested: *
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If Other, please explain:
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Total Time Requested: *
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Comments/Notes to the Hiring Manager or Personnel Office:
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A copy of your responses will be emailed to the address you provided.
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