Time off Notice Form

Please list all languages you interpret. You do not need to list English.
You must complete one form for each day you will be out
How many hours will you be out that day?
Paid time off will only be applied if you have any available in the current year. If you select “yes” but don’t have enough, only your available paid time will be applied.
Anything you want to clarify? Also if the number of hours you will be out don’t match your daily hours, let us know you will only be out for partial days.