Form for Academy/Learning Center Staff

Day Off Request
Do not assume that time off is approved. Approved requests will be returned to you signed by Director at the bottom of the form.

* Indicates required field

Name *

First

Last

Today's Date *

Email *

Phone Number *

Date Requesting Off *

Reasons for request *

FOR FULL-TIME EMPLOYEES ONLY: If you believe you have paid time off and you would like to use it, mark yes. If not, leave blank. *

Yes

Signature for Approval:_______________________ Date: ________________

Submit