JFC JDS Additional Availability/Request to open schedule

This form supports up to 5 dates per submission.

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This field is for validation purposes and should be left unchanged.
Employee Name*
Days of Additional Availability/Request to Open Schedule*
Requested to Open (Day 1)*
MM slash DD slash YYYY
Start time (Day 1)*
Remember select AM or PM (AM is automatically populated)

: Hours

Minutes

AM/PM
End Time (Day 1)*
Remember select AM or PM (AM is automatically populated)

: Hours

Minutes

AM/PM
Requested to Open (Day 2)*
MM slash DD slash YYYY
Start time (Day 2)*
Remember select AM or PM (AM is automatically populated)

: Hours

Minutes

AM/PM
End Time (Day 2)*
Remember select AM or PM (AM is automatically populated)

: Hours

Minutes

AM/PM
Requested to Open (Day 3)*
MM slash DD slash YYYY
Start time (Day 3)*
Remember select AM or PM (AM is automatically populated)

: Hours

Minutes

AM/PM
End Time (Day 3)*
Remember select AM or PM (AM is automatically populated)

: Hours

Minutes

AM/PM
Requested to Open (Day 4)*
MM slash DD slash YYYY
Start time (Day 4)*
Remember select AM or PM (AM is automatically populated)

: Hours

Minutes

AM/PM
End Time (Day 4)*
Remember select AM or PM (AM is automatically populated)

: Hours

Minutes

AM/PM
Requested to Open (Day 5)*
MM slash DD slash YYYY
Start time (Day 5)*
Remember select AM or PM (AM is automatically populated)

: Hours

Minutes

AM/PM
End Time (Day 5)*
Remember select AM or PM (AM is automatically populated)

: Hours

Minutes

AM/PM
NOTES
Email*

Please note: A copy of this request will be cc'd to you upon successful submission and management will be following up with you by replying to this email address.
Acknowledgment and Acceptance*
- AM or PM has properly been selected for the submitted dates AND I understand that this request will be reviewed for approval.

JFC JDS Additional Availability/Request to open schedule

JFC JDS Additional Availability/Request to open schedule

Awards & Affiliations

Street Smarts of Maryland