Page 50 - 2018 Summer Employee Handbook

Clinton Township Recreation
40700 Romeo Plank Rd., Clinton Township, MI 48038 Phone: (586) 286-9336 Fax: (586) 723-8282
ABSENCE FORM
Seasonal employees working for the Charter Township of Clinton Recreation department are required to show documentation for any situation that may require them to be absent for any or all of their required shift. All time off requests must be submitted on this form.
In order to insure that you will in fact be eligible for an excused absence, you must fill out Part 1 of this form, (which serves as a Time-Off Request) and submit a completed copy to the staff at the CTPR Office at least two (2) weeks prior to the date needed. The original will be reviewed and returned to youThen, take the original and have the camp, college, court, doctor, or funeral home certify your absence on part 2 of this form and return it to the Recreation office prior to the start of the next work-day. Lack of, or incorrect documentation, may result in disciplinary action until the proper information is turned in. You will not be eligible for an excused absence until this form is completed, received, and reviewed. Decision made by the administration will be final.
Part 1- TIME OFF REQUEST- to be completed by the CTPR Employee
AM
PM
 Full Day I hereby certify that I ________________________ will be absent from work _________________________
(Name of CTPR Employee) (Day & Date)
Due to ___________________________________ at ___________________________________________ (Reason for Absence) (Name of Organization)
Signature of CTPR Employee: _________________________________ Site:_______________________
Part 2- ABSENCE DOCUMENTATION- To be completed by the Camp, College, Court, Doctor, or Funeral Home, or attach a signed document from the source. NOT a confirmation letter or flyer.
_____________________________ hereby certify that __________________________________________
(Name of Organization) (CTPR Employee)
Was present for _______________________________________ on ________________________________
(Reason for absence)
By:_________________________
Phone Number:__________________________
(Day & Date) Title:____________________________
Date:____________________________
PAGE | 48 2018
Office Use Only
□ Approved – Not excused
□ Approved – Excused with proper documentation