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Dylan Silliphant
2018-02-01T16:15:14+00:00
Pay Stubs:
Electronic Paycheck Services
Time and Labor:
PayChex: Time and Labor
Vacation Request Form
Absence Information
Employee Name:
*
First
Middle
Last
Employee Number:
*
Department:
*
Department Supervisor:
*
Type of Absence Requested:
*
You must submit requests for absences, other than sick leave, 72 hours prior to the first day you will be absent. Please note that if request is submitted after payroll has processed, it will be considered "time off without pay". Form must be filled out
completely
to be considered for approval.
Sick 05-5220
Jury Duty 05-5280
Holiday 05-5230
Time Off Without Pay 05-5260
Admin Leave 05-5240
Vacation 05-5210
Bereavement Leave 05-5240
Maternity/Paternity 05-5270
Start Date and Time:
*
End Date and Time:
*
Reason for Absence:
*
Total Number of Days Requested:
*
Total Number of Hours Requested:
*
If using vacation time please list number of hours you wish to use:
Employee Name
*
Date:
*
Any Questions?
Employee Name (required)
Employee Email (required)
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