Sick Time Form

An employee eligible for Sick Time shall be granted for the following reasons:

• Personal illness or injury

• Illness of an employee's spouse, parent, child

• Medical, dental, or optical appointment

• After bereavement leave (refer to section 5.6) has been used for the death of an employee's mother, father, brother, sister, child, grandparents, grandchild

• Sick Time may be used for Annual Shutdown only

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An employee who is absent from work for any of the reasons set forth above is responsible for reporting the basis for absence to the appropriate supervisor, by telephone or personal message prior to the start of the work day.

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An employee will be expected to keep the supervisor informed of progress on a daily basis (unless instructed otherwise) when the absence extends beyond one (1) working day.

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Failure to do so may be cause for denial of Sick Time with pay for the period of the absence.

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Doctors excuse is required starting the 4th day absent or for any scheduled appointment at a doctor.

Please fill out below and submit for approval