Pro Edge Absense Request Form

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Pro Edge Absense Request Form Powered By Docstoc
					                                             ABSENCE REQUEST FORM

Surname:                                                   Forenames:

The following time off work is requested:

Period:            From:                                                To:
                   If part of day, beginning at:           am/pm to             am/pm
                   Working day return date:

                   Remaining Hours Entitlement  ________
                   Hours requested             ________
                   Total Hours Remaining       ________

Reason for
absence:
                               Annual holiday                                 Death of near relative


                               Appointment for doctor, clinic,
                               optician, dentist, other (please               Territorial Army
                               specify below)


                               Hospital attendance                            Family responsibilities


                               Jury/witness duty                              Emergency leave for dependants


                               Parental leave                                 Other (please specify below)


                   Extra Details:


To be completed when absence was not approved in advance.
I was absent on (dates):

for the following reason:

Reason why prior approval was not sought:


Employee’s signature:                                             Date:
Authorisation for time off:
With pay according to entitlement:                                Without pay:
Manager’s signature:                                              Date:

				
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posted:9/14/2012
language:English
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