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SHIFT CHANGE REQUEST FORM

Date: ____________________

Day: ____________________

Name of person WHO CANNOT work the shift:


______________________________________________________________
Name of the person WHO AGREED to work the
shift:________________________________________________________
Department:
______________________________________________________________________________________
_______________
Actual Shift: Date: ______________ Time: ____________to_____________
Shift Change Requested:
Days:
______________________________________________________________________________________
_______________________
Date:
______________________________________________________________________________________
_______________________
Time: ____________to_____________
Reason for Request:
__________________________________________________________________________________
Official action on request: Approved
________________________

Disapproved
_____________________

__________________
Signature of employee
of HR

Signature of HOD

Signature

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