A F L Cleaning Services

"Planned" absence "MUST" be submitted TWO WEEKS in advance for approval. Unplanned must also be submitted for record keeping purposes. (See page 6 of the Policy & Procedures Handbook.)

Today's Date:

Employee's Full Name:

Employee's Job Site(s)/Location(s):

Dates of Absence:

First Date of Absence: (mm/dd/yyyy)

Date to Return back to Work: (mm/dd/yyyy)

Type of Absence: (for consideration purposes)

Check all that apply:

Bereavement (Provide name, relationship, date of decease, date of services and funeral home, in comment field)
Surgical Procedures:
Jury Duty:
Maternity/Paternity Leave of Absence
Vacation
Sick
Family sickness/emergency
Other (Please provide details.)

Additional Details:

Please ensure you receive a "successful submitted" statement upon submitting your request. You will be contacted with regards to this request.