MOH Absence Notification Form

Name *

First Name

Last Name

Phone *

(###)

###

####

Where do you service? *

Please select all the locations you serve in

Nursery

Preschool

Elementary

Youth

Greeter/Doorman

Usher

Security

Oasis Café

Welcome Center

Worship Team

Front of House Media

Front of House Sound

Front of House Lights

Livestream Cameras

Manned Camera Operator

Photography

Other

What service do you serve in? *

Sunday AM

Wednesday PM

Absence Start Date *

Enter the first service you will be gone.

MM

DD

YYYY

Absence End Date *

Enter the last service you will miss. (If just one service, then repeat the date.)

MM

DD

YYYY