Winter Holiday Time Off Request Form
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Name
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First
Last
Your Address
Street Address
City / Town
Your Email
Please remember we have a high volume of requests for staff time off during the holidays. Planning is critical and we will do our best to approve as many of these requests as possible.
Please Identify which Holiday is your priority via the drop down menu for Thanksgiving, Christmas Day and New Years Day.
My FIRST CHOICE HOLIDAY is:
Thanksgiving, November 24
Christmas, Sunday, December 25
New Years Day, Sunday Jan 1, 2023
SECOND CHOICE HOLIDAY (1st choice is New Years Day)
Thanksgiving, November 24
Christmas, Sunday, December 25
No other Holidays Requested
THIRD CHOICE HOLIDAY
Christmas, Sunday, December 25
I do not have a Third Choice
Your second choice was Thanksgiving
THIRD CHOICE HOLIDAY
Thanksgiving, November 26
I do not have a Third Choice
Your second choice was Christmas
SECOND CHOICE HOLIDAY (1st choice is Christmas)
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Thanksgiving, November 24
New Years Day, Sunday Jan 1, 2023
No other Holidays Requested
THIRD CHOICE HOLIDAY
New Years Day, Sunday Jan 1, 2023
I do not have a Third Choice
Second choice was Thanksgiving
THIRD CHOICE HOLIDAY
Thanksgiving, November 26
I do not have a Third Choice
Second choice was New Years Day, Friday January 1, 2021
SECOND CHOICE HOLIDAY (1st choice is Thanksgiving)
Christmas, Sunday, December 25
New Years Day, Sunday Jan 1, 2023
No other Holidays Requested
THIRD CHOICE HOLIDAY
New Years Day, Sunday Jan 1, 2023
I do not have a Third Choice
Second Choice was Christmas Day
THIRD CHOICE HOLIDAY
Christmas, Sunday, December 25
I do not have a Third Choice
Second Choice was New Years Day
You may also select 1 day before and 1 day after whichever holiday you have marked as your #1 choice.
Would you like the Day BEFORE and/or AFTER Thanksgiving off? (choose day(s))
Wednesday, November 23
Friday, November 25
No additional Days Requested
Would you like the day BEFORE and/or AFTER New Years Day off? (choose day(s))
Saturday, December 31, New Year’s Eve
Monday, January 2, 2023
No additional Days Requested
Would you like the day BEFORE and/or AFTER Christmas Day off? (choose day(s))
Saturday, December 24, Christmas Eve
Monday, December 26
No additional Days Requested
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If you wish to be off on
MORE than ONE holiday
or additional days surrounding the holiday, you will be placed on a wait list. These request(s) may be approved as we get closer to the holiday, should your clients not need services, or we can find replacement coverage. Please do not make official plans until you are notified your request for holiday time off is “Approved”. We will continue to keep everyone updated about holiday time off. Thank you for your cooperation.
If you want to work these holidays/or the days surrounding them, please let us know by November 1, 2020.
This will help greatly in trying to meet staff requests for time off and our client’s needs. If you have any questions, please call a Client Care Coordinator.
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