REQUESTS MUST BE MADE IN WRITING, EXCEPT IN CASES OF AN EMERGENCY, AND MUST BE MADE IN ACCORDANCE WITH THE ATTENDANCE POLICY. DO NOT MAKE PLANS UNTIL YOU HAVE RECEIVED THE APPROVAL OF THE MANAGEMENT THAT THE DAYS YOU ARE REQUESTING ARE AVAILABLE. REQUESTS ARE TAKEN INTO CONSIDERATION ON A FIRST COME FIRST SERVE BASIS. WEAPPRECIATE EVERYONES COOPERATION. THANK YOU.

Employee Last Name	*
Employee First Name	*
e-mail	*
I am formally requesting that I be given the following day(s) off:
From:	*
To:	*
I will be back at work:	*
Shift Replacement	*	Day time Evening Saturday Sunday See Notes
Who is going to cover for you? And what arrangements have you made?	*
I understand that I am not guaranteed to get the above day(s) off that I have requested until approval has been given. I also understand that the approval or denial of my request will be based on full coverage of times and dates requested. I also understand it is my responsibility to find a replacement for my scheduled shift(s) and have them in place before my request can be made.
	*	I acknowledge having read and understood the above information.
Comments:
Security Code	*