Vacation Request

Name

Date Submitted

According to policy, I would like to request the following dates for vacation this year:

Calendar Dates

Total Vacation Days Used

In case of emergency, I can be located through the following:

Emergency Contact 1 (Provide name & phone number)

Emergency Contact 2 (Provide name & phone number)

Pastor's Church Information

1. Church Name

Date

Speaker

2. Church Name

Date

Speaker

3. Church Name

Date

Speaker

Additional Information

Comments