* = Required Information
Time Off Request Form - Salaried Employee
* As stated in the Staff Reliability Policy, Zumbro House requests a tow week notice for time off. Requests should be submitted via this form, which will be automatically submitted to your
First Name
*
Last Name
*
Telephone
*
Email:
*
Location current working at:
*
3223 14th Ave. S
2446 15th Ave. S
2527 14th Ave. S
778 Blair Ave.
Date Requesting off
*
Date Requesting off
Date Requesting off
Date Requesting off
Date Requesting off
Supervisor's Name
*
Addtional notes
Submit