Employee Absence Form Your Name* First Last Branch*BrandonCalgaryCentral WarehouseChathamCorporateEdmontonGrande PrairieLangleyLethbridgeLloydminsterMississaugaOakbluffRed DeerReginaSarniaSaskatoonSudburyThunder BayWinnipegEmployee Name* First Last Title*Counter SalesAM SalesTrailer SalesParts HandlerShipper/ReceiverMechanic/TechDriverAdminManagerOtherOther (Please detail) First Day of Absence* MM slash DD slash YYYY Return to Work Date (if known) MM slash DD slash YYYY Days of AbsenceLeave of Absence Reason*All vacation absences are to be recorded in PayworksIsolation Due to SymptomsChildcareIsolation Due to TravelBereavementIsolation Due to ExposureOther Illness (please include details below)Other Absence (please detail in Other Information)Other Illness (Details)Other InformationDoes the Employee Qualify for COVID Testing?* Yes No Approval Requested to Work From Home* Yes No Other Information
