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Time Off Requst Form

Have your employees fill out this time off request form for them to receive approval to take time off from work.

Business Network Members
  1. Blue Light Lounge
  2. S'boro JS
  3. Integrity Designs & Marketin
  4. A Plus Appliance Service

Time Off Request Form

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Time Off Request

Please Check One:

[__] Vacation

[__] Personal Holiday

[__] Sick Leave

[__] FMLA

[__] Leave w/o Pay

[__] Summer Leave

[__] Other

Other: _____________________________



Name: ______________________________

Date Submitted: ____/____/_____

Total Number of Days Requested: _____

Starting Date: ___/___/_____

Return to Work: ___/___/_____

Approved By: _______________________Date: ___/___/_____

Business Network Members
  1. AOSS Medical Supply Inc
  2. Parker Health Care Services
  3. Floor Craft
  4. Greenleaf Group LLC

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Employee Scheduling
Overtime Authorization
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Request Time Off
Time Off Request
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