Creative Break Leave of Absence Request
Submit your request for a creative break or leave of absence within the entertainment or creative organization.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Department or Role
*
Please Select
Actor/Performer
Director
Writer
Production Crew
Music/Sound
Design/Art
Marketing/PR
Administration
Other
Type of Leave Requested
*
Personal Creative Break
Medical Leave
Family/Emergency
Other
Leave Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Leave End Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Please provide the reason for your creative break or leave of absence
*
How will this leave affect your current projects or responsibilities?
*
Supervisor or Manager Name
*
Upload any supporting documents (optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Signature (please sign to confirm your request)
*
Submit Request
Submit Request
Should be Empty: