JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Request For Time-Off
To request any sick hours, please fill out the Request for Sick Hours form:
https://forms.gle/A87rXEWmSzQNGpmN9
Sign in to Google
to save your progress.
Learn more
* Indicates required question
First and last name
*
Your answer
Start date and time- (Ex: 7/18/24, starting at 8am; 7/20/24, all day or 10/9/24, starting at 6pm)
*
Your answer
End date and time (Ex: 7/18/24, ending at 10pm; 7/20/24, all day or 10/10/24 ending at 6pm)
*
Your answer
Type of leave
*
Sick leave (Illness, Injury or bereavement)
Personal leave
Emergency leave
Leave of absence
Other:
Reason for leave
Your answer
What service are you requesting time off for?
*
ARCC Center Respite
ARCC Center ABA
Both
Do you have any scheduled sessions that you will need a backup for? If so, refer to "Future Sessions" form. You will find this link in our website and can list the shifts that are cancelled and need a backup.
*
Yes
No
Other:
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of ARCC Center Foundation, Inc..
Report Abuse
Forms
