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Absence Reporting

Complete this form to report your absence.

Employee Name*

Answer required for "Employee Name"

E-mail address

Answer required for "E-mail address"

Absence Date*

Answer required for "Absence Date"

Duration

Answer required for "Duration"

1/4 Day

1/2 Day

3/4 Day

Full Day

Reason

Answer required for "Reason"

Sick

Vacation

Bereavement

Jury Duty

Association Leave

Confirmation Email

Confirmation Email *

Answer required for "Confirmation Email"