Absence Request Form
If you need to request time off for any reason, please fill out this form. The form will be reviewed and approved or rejected in a follow up email.

Requests for absences, other than sick leave, must be submitted two days prior to first day of absence.

Vacation time off must be submitted at least 30 days in advance.

Employee Name *
First and Last
Your answer
Department
Your answer
Manager
To whom do you answer?
Your answer
Type of Absence Requested: *
Required
Date of Absence *
MM
/
DD
/
YYYY
Is this absence for multiple days? *
If yes, when will you return to work? *
MM
/
DD
/
YYYY
Employee Signature *
Please type your full name and date to verify form was submitted.
Your answer
Submit
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