Release Time (Sick Day / Personal Time)

Release Time (Sick Day / Personal Time)
For bookkeeping purposes, the minimum request for sick time/days is 2 hours, or .25 (quarter) of a day. Personal Days must be pre-approved per employee handbook.

This is my (employee name)   request to utilize contractual release of (#)   SICK DAY(S) or (#)   PERSONAL DAY(S) on (date/s)  .

Employee's Signature:
Program Supervisor's Signature:
Director's Signature:

_____ Approved
_____ Not Approved
Number of Days Remaining ___________

Please print and sign then submit to Program Supervisor.