Staff Member Name:
E-mail Address:
Supervisor's E-mail Address:
Date(s) Requested Away:
Reason:
Other Staff Member Covering Your Area (Please consult with individual prior to completing this form)
Name of other Staff Member
Contact Information while away:
This is due on the Monday before you would like to be away. Thank you.
© 2008 Hope College | Residential Life & Housing | 141 E. 12th St. | Holland, MI 49423 housing@hope.edu | phone: 616.395.7943 | fax: 616.395.7183
