Sick Hours Request Form

Date January 9, 2022, 2:54 p.m.
Team Member Name (First and Last)
Jacob McFarland
Team Member Email (A copy of this request will be sent to the Team Member) [email protected]
Location 8261
16738 Lakeshore Drive Ste K
Lake Elsinore, CA 92530
951-245-2882
Position and Hours
Dates Called Off January 5, 2022
If Multiple Days please list dates here;
1/7, 1/8
Hours Scheduled to Work (Start Time & Approx. end Time)
12-830, 1-9
Picture of Schedule Showing the dates they were scheduled to work
Hours Requested By Team Member 24
Submitted By:
Kristin Murga
Manager Signature

Please note that Sick Hours may be approved, however the Payroll Department will only be able to provide Sick Hours if hours are avail. This notice is for initial approval. For example: a team member may request 16hrs and will be approved, but the payroll department may only have 10hrs avail to give based on Team Members hours available.