Staff Time Off Form Today's Date * MM DD YYYY Employee's Name * Email * Date(s) Requested * I am requesting the whole day off * Yes No I am requesting part of the day off From Hour Minute Second AM PM To Hour Minute Second AM PM Is this request at least two weeks in advance? * Yes No Is this date available on the time off calendar? * Yes No Teacher Coverage Are you covered within your classroom pod or is additional coverage required? Classroom Pod Additional Coverage [If Pod] Outline coverage plan within your pod Are you switching shifts with another teacher? Yes No [If Yes] Initials of Employee who is agreeing to switch Thank you! The admin staff will review your request and respond as soon as possible.