The Autism Academy of Learning

Time Off Request Form

This is an electronic version of the AAL time off request form.

Required *

Employee Name * Enter your name here

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Room Assigned * Enter the room where you work

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Your email * Enter your email address

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I hereby request: * What type of day are you requesting?

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Number of days off * How many days will you be taking off?

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When will your time off start?

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When will your time off end? Enter the day your time off will end

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If your time off is less than one day please explain If time off is less than one day please provide number of hours, start time, and end time.

Reason for time off * Please select

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If related to a worker's comp claim please provide the name of the doctor, date of the initial injury, and claim number

Approval Status

Date of status change Date that the status was marked

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The Autism Academy of Learning

219 Page St.

Toledo, Ohio 43620

Phone: (419) 865-7487

Fax: (419) 865-8360

info@theautismacademy.org

For specific inquiries visit the contact us page.