Please Read Before Submitting:
    (Attention: Attendance Policy Changes Starting June 1, 2025)

  1. Submitting this form is required for all absences. Attendance points will be applied based on the timing of your submission:
      0.5 point if submitted with MORE than 4 hours notice. (10 hours for Night Shift)
      1.0 point if submitted with LESS than 4 hours notice.
      2.0 points if no notice is given (No-Call No-Show).
  2. If you cannot provide sufficient notice online, especially for evening or weekend shifts, submit this form and contact a supervisor immediately:
  3. When You Return to Work:
      Update your absence in ADP if you wish to use paid time; otherwise, the time will be coded as unpaid.
      Provide a doctor’s note if absent for 3 or more consecutive days.
      Discuss possible make-up hours with your manager, subject to approval.
  • MM slash DD slash YYYY
  • Please use this form only to notify management that you are unable to attend your scheduled shift due to unforeseen circumstances and cannot provide sufficient notice. This is not a time-off request form.
  • Please include any key details to help us manage your shift coverage—such as your estimated arrival time (if late), expected return date (if absent), or other relevant information. Avoid including personal or medical specifics. This section helps leadership respond appropriately while maintaining your privacy.
  • This field is for validation purposes and should be left unchanged.