Time off Notice Form – Language Interpretation and Translation Services

Your Name *

First

Last

Email *

Language(s) You Interpret *

Please list all languages you interpret. You do not need to list English.

What Time Do Your Shifts Begin *

What Time Do Your Shifts End *

How Many Hours are you Scheduled Per Day? *

First Date Out *

Please select the first date you would like off

Last Date Out *

Please enter the last date you’d like off. If you are only taking one day, This date should should be the same as “First Date Out”

Total number of hours you will be out *

Please add up the total number of hours you will be absent. If you will be out more than one day, add all the hours across all days.

If you have Paid Time Off, Would You Like to Use any For This? *

Yes, Please Use Paid Time Off
No, Time off Will be Unpaid
N/A I do not have Paid Time Off

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 to explain?

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.