Time Off Submission Time Off Submit Name(Required) First Last Email(Required) Keep All Requests in the Same WeekIf less than 2 week notice, you must talk to management. Call Office. Leave Voicemail. (859) 303-4040Sunday MM slash DD slash YYYY Sunday – Time (Hrs)Max 8 hrs per dayMonday MM slash DD slash YYYY Monday – Time (Hrs)Tuesday MM slash DD slash YYYY Tuesday – Time (Hrs)Wednesday MM slash DD slash YYYY Wednesday – Time (Hrs)Thursday MM slash DD slash YYYY Thursday – Time (Hrs)Friday MM slash DD slash YYYY Friday – Time (Hrs)Saturday MM slash DD slash YYYY Saturday – Time (Hrs)This field is hidden when viewing the formTotal Amount of Time RequestedMax 40 hrs in a weekComments / Requests / ExplanationUse PTO(Required) Do Not Use PTO Sick Vacation Consent(Required) I agree to the Independence Assistance’s “Paid Time Off” policies.
