Professional Day Request
Please submit the times you need to take off work and the type of leave you are taking. No arrangements should be made (registration, lodging, etc.) without completing this request.
Email address *
Employee Name *
Your answer
Conference Name *
Your answer
Conference Date(s) *
Your answer
AM/PM/All day *
Travel Dates (N/A if not needed): *
Your answer
AM/PM/All day *
Conference Registration Costs ("$0" if free) *
Your answer
Hotel Costs ("$0" if no hotel is needed) *
Your answer
Mileage/Transportation Costs (Anticipated) *
Your answer
A copy of your responses will be emailed to the address you provided.
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