Vacation Request/Absence Complete this form at least two weeks prior to desired time off and not later than five days subsequent to return from absence due to illness or an unplanned emergencyName First Last Reason for Absence* Vacation Sickness or Injury Bereavement Birthday Other Other*PaidNon_PaidDates of Vacation/AbsenceFrom Date* MM slash DD slash YYYY To Date* MM slash DD slash YYYY # of Work Days Off*# Of Regular Days Off*Email* Δ
