Time off request
Please submit the times you need to take off work and the type of leave you are taking.

Email address *
Name *
Your answer
Leave date(s) *
Your answer
AM/PM/All day *
Type of leave
Type of leave *
Description if needed. Fusce dapibus, tellus ac cursus commodo, tortor mauris condimentum.
Reason for leave
Your answer
Substitute Preference *
Your answer
Admin Section Only - Do not fill out anything below this section
Admin. Approval
Please see an Administrator
A copy of your responses will be emailed to the address you provided.
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