Request Form

Employee Name(required)

Email address(required)

This request is for a:(required)

Date of absence:(required)

Explain in detail work that will be performed by staff or while using company equipment:(required)

Reason for absence explained:(required)

Who will cover in your absence?(required)

What type of equipment are you requesting?(required)

When will you return equipment?

All equipment borrowed must be returned to Warehouse Manager

**I understand that if I am scheduled to be ON-CALL during this time period, it is my responsibility to complete & get an approved on-call switch form or alert the Supervisor my willingness to fulfill my ON-CALL duties.**

Supervisor Signature

This must be signed and returned in order to be active.

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