Vacation Request Form Template ESU NO 5 REPORT REQUEST OF ABSENCE FROM ASSIGNED

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Vacation Request Form Template ESU NO 5 REPORT REQUEST OF ABSENCE FROM ASSIGNED Powered By Docstoc
					        ESU NO.5 REPORT/REQUEST OF ABSENCE FROM ASSIGNED DUTIES


I.    Select reason for absence:                    BEREAVEMENT LEAVE                                  DATE(S):           Enter Date          to     Enter Date
                                                                                                       TIME(S):           Enter Time          to     Enter Time


II. Specify reasons for this request to be absent. (Submit as soon as possible, preferably at least one week in advance.)




III. In reporting an absence, submit a statement of conditions for being absent. (Applies when written approval was not
     received in advance.)




     Whom did you notify that you would not be at work?                                                      Click here and type that name


     Your Name:                      Click here and type your name                                             Please enter all requested information
                                                                                                                 on this form, and then print it out.
     Date:                         Click here and type today's date                                              Have your supervisor sign & date
                                                                                                                      the form, and send it to:

                                                                                                                          JAN REIMER
     Supervisor                                                                                                   Educational Service Unit No. 5
     Signature:                                                                                                      900 West Court Street
                                                                                                                      Beatrice, NE 68310
     Date:




                                      APPROVED: o                                      NOT APPROVED: o
       --------------------------------------------------------------------------------------------------------------------------------------

       Recommendation / Action Taken: ...................................................................................................

       Recorded by: ........................................................... Date: ............................................................
HOW TO SAVE THIS FILE
This file is a "Template" file. That means whenever you open it, you get a fresh, clean file.
When you are ready to save the file you are working on, simply select File ► Save.


After you click Save , the Save As dialogue
box opens automatically:




In the File Name line, enter the new name
for your file, following this format:

[Your Name] Request [Year] [Month]

Example:
Sally Smith Request 2007 01


Click the                button




Now you are ready to print out your request form.
Please have your supervisor sign the printed form, and then mail it to Jan Reimer.

				
DOCUMENT INFO
Description: Vacation Request Form Template document sample