_________________________________________(PRINT YOUR NAME) would like to be released from work on:
Date________________________________________________________________
Day ________________________________________________________________
Requested____________________________________________________________
Employee Signature ___________________________________________________
In case other employees request the same day off, please note any pertinent information.
Comments__________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
This request is not confirmed until it appears on the master schedule with the Manager’s Signature.
Date Approved________________________________
Manager Signature_____________________________
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