Page 81 - FY21_LawsonAcademy_FacultyHandbook

EXHIBIT D: REQUEST FOR TIME OFF

Request for Time Off Form

To be completed by employee prior to absence.

Date submitted:

Employee’s Name:

Date(s) Requested:

❑ Sick leave.
❑ State leave.
❑ Vacation leave.
❑ Jury duty.
❑ Other:

Comments:

Employee’s Signature:

❑ Time off granted as vacation leave. ❑ Time off granted with pay.
❑ Time off granted as sick leave. ❑ Time off not granted.
❑ Time off granted without pay.

Supervisor’s Signature:

Approval Date:

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