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EMPLOYEE VACATION REQUEST FORM

Employee Name:
Rocket #:
Supervisor:

Department:
Vacation Effective Date:

Hours Balance:
Seniority Date:

Please indicate vacation dates


Approved
Start Date: ____/____/____

Return Date:

____/____/

Start Date: ____/____/____

Return Date:

____/____/

Start Date: ____/____/____

Return Date:

____/____/

Start Date: ____/____/____

Return Date:

____/____/

Start Date: ____/____/____

Return Date:

____/____/

Start Date: ____/____/____

Return Date:

____/____/

Denied

Employee Signature: _____________________________________________

Date: ____/____/____

Supervisor Signature: _____________________________________________

Date: ____/____/____