Unexcused Absence Notification

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This form is in place to provide team members with a streamline process to notify WIREONE of an unexcused absence.

-Team members are to use this form any time there will be an unexcused absence which does not meet PTO requirements.

-Please understand unexcused absences negatively affect our ability to serve customers and other team members, as a result this may require disciplinary action.

-Please be as descriptive as possible with your answers.

Email *

Name *

I will be absence from my scheduled shift *

Yes

I will be tardy or need to leave my shift early. *

Yes

Date in reference to the absence or shift alteration? *

YYYY

What hours will you be absent from your shift? *

What is the amount of time you expect to miss? *

< 1 hour

1-2 hours

2-4 hours

4-8 hours

Complete day

Multiple days

Date you intend to return to your scheduled shift? *

YYYY

Please explain why you are unable to report for your complete scheduled shift. *

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