Extended Day Schedule Change Request and Triage Plan Form

**Please note this form is intended for partial day requests only (i.e. leaving early, coming in late, switching shifts etc.). If a staff member needs an entire day off, they should follow the procedure in AOD and request the time off to utilize PTO.**

Today’s Date:

Employee Name:
      	 
Classroom: 

Regular Schedule:
     
Date of Schedule Change:     	
	
Schedule Change AND triage plan: 

Reason for Schedule Change:

Is a Sub necessary to cover this time?    Yes    or No 

**Please note if you do not have PTO to cover the requested time, it will be considered unplanned. Whenever possible, staff should schedule appointments at the beginning or end of the day.

Purpose:  All staff members have a designated work schedule that has been designed to best meet the needs of the children and families Promise Early Education Center serves as well as ensure staff are available for meetings and various professional development engagements.  This form should be utilized when a staff member needs to make a one-time change to their regular schedule to accommodate a personal appointment and or other outside commitment.  
     
Please submit to your supervisor at least five business days before your schedule change.  You will hear if your request has been approved or denied within three business days.