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Southwestern Michigan College

Vacation Request Form

Employee Information
Enter 4 digit dept. # above.
Immediate Supervisor Approval
Enter the email address for the supervisor who approves your vacation requests in the space provided below:
Paid Time Off Request Details

To streamline the processing of this form by the Human Resources Department, please limit the start and end dates provided on a single Vacation Request form to dates which fall within the same month. However, you may include end dates that cross over into another month.

For example, if you are taking the whole week of 6/29 off, you may include all dates in that week on a single request including those which fall within the month of July.

Row 1
Round to nearest 1/4 hr
{hh1}+{mm1}/60
Row 2
Round to nearest 1/4 hr
{hh2}+{mm2}/60
Row 3
Round to nearest 1/4 hr
{hh3}+{mm3}/60
Row 4
Round to nearest 1/4 hr
{hh4}+{mm4}/60