Request Off Form - Pine Valley Swim And Tennis Club

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REQUEST OFF FORM
Employee Name:____________________________
Position:______________________
Date(s) Requesting Off:________________________________________________________
Employees Signature:________________________________________ Date:____________
Approved
___yes
____ no
(Employee can prearrange coverage And complete the substitute portion prior to obtaining approval)
Reason For Denial:
_____________________________________________________________________________
_____________________________________________________________________________
Supervisors’ Signature:_________________________ Date: ____________
SUBSTITUTE INFORMATION
___________________________ will be working for __________________________
( substitute employee )
( scheduled employee )
on __________________, _________________________, 20___ from ___________ am / pm
( day of week )
( month and date )
( circle one )
to _______________ am/ pm.
( circle one )
Scheduled employee signature ______________________ date ________________
Substitute employee signature ______________________ date ________________
Supervisors’ Signature ______________________________ date ________________
It is the scheduled employee’s responsibility to make sure that this paper is filled out completely,
including both employee’s signatures, and turned into the office with a managers signature.
Failure to comply with this policy could lead to reduction of hours and possibly termination.

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