COAHOMA&COMMUNITY&COLLEGE&
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!!!!VACATION!REQUEST!FORM!
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Name_________________________________________________________________________&
Date&of&request_________________________________________________________________&
Number&of&days&to&be&taken_______________________________________________________&
Starting/ending&dates____________________________________________________________&
Date&returning__________________________________________________________________&
Employee&signature______________________________________________&Date__________________&
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Please!secure!the!following!signatures!before!submitting!to!Employee!Services:!
! ! ! ! ! ! ! ! Approve!!!!!!!!!!!!!!!!!!!Disapprove!
_______________________________________!! !!!!!!!!!!!!!!!!!!!![!!!!]!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!![!!!!]!
Supervisor!
_______________________________________!! ! !!!!![!!!!]! ! ! !![!!!!]!
Divisional!Dean/!Director!
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Submit'approved'Vacation'Request'Form'to'Employee'Services'for'verification'two'weeks'prior'to'
leave'request.'
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_____________________________________!!!!!!!!!!!!!!!!!!!!!!!!!!!!![!!!!]!!!!!!!!!!!!!!!!!!!!!!!!!!!!!![!!!!]!
Director!of!Employee!Services/Human!Resources!!!
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NOTE:!!PPM,!page!17:!!Leave!may!not!be!requested!on!the!first!or!last!days!of!the!school!terms,!or!on!the!days!
before!or!after!recognized!federal!or!state!holidays.!