The version of the browser you are using is no longer supported. Please upgrade to a
CTHS Request for Leave
Please submit the times you need to take off work and the type of leave you are taking.
Type of Leave
Description if needed. Fusce dapibus, tellus ac cursus commodo, tortor mauris condimentum.
Sick leave (Illness or Injury)
Bereavement leave (Immediate Family)
Bereavement leave (Other)
Jury duty or legal leave
Leave without pay
Reason for Leave
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of SCVTS.
Terms of Service