; Exceptions Easter Seals Goodwill Northern
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Exceptions Easter Seals Goodwill Northern

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									                                         Easter Seals-Goodwill Northern Rocky Mountain
                                                        Exceptions Form
     Employee Name: ____________________________________ Home Department: ___________________ Badge #: ___________________

                 DAY             SUN           MON          TUE            WED            THU            FRI            SAT
                 DATE
                   IND
   Missed          OUTL
  Punches           INL
   (Write
                  OUTD
   actual
   Time)           IND
                  OUTD
               Type Enter:
 Time Off       PTO, STM,
 Request       Wellness, Jury
                or Funeral
                 # Hours

       On-Call Hours

Department      Dept Code:
 Transfer        # Hours

                 Job Code:
Job Transfer
                 # Hours:


     EXPLANATION: ________________________________________________________________________________________________

     Employee Signature: _____________________________________________ Date: ____________________________________________


     Request: ____ Approved     ____ Denied ____ Pending       ____Documented in EmpowerTime by: _________________________

								
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