Schedule Change(s) Request Form

Please complete the form below to submit schedule changes, substitutions, request off or to change your availability.

Note: Submission of this form does NOT guarentee you will be granted the request change or time off. All submissions must be approved by a department manager or General Manager. 

Name: *
Name:
Phone: *
Phone:
I am submitting this request for: *
Why are you submitting this form?
Employee Statement: *
I hereby certify that I (the employee listed above) is submitting this form on behalf of myself only. For schedule changes and shift swapping: I have verified with the other employee who will accept my shift change and understand that if that person does not arrive at the scheduled shift time, I (as well as the other employee) may be subject to disciplinary action.