Name *

First Name

Last Name

Todays Date *

MM

DD

YYYY

Time Requesting Off *

"Scheduled Sick Days" would include known surgeries, known time off for kids surgeries, etc. Everything else is "Scheduled Non Sick Days"

Scheduled Sick Day(s)

Scheduled Non-Sick Day(s)

Date off BEGIN *

This is the first day you will be taking off.

MM

DD

YYYY

Date off END *

This is the last day you will be taking off.

MM

DD

YYYY

Date returning to TRU *

MM

DD

YYYY