Officer Furlough Log - 2026
Approved Date
-
Month
-
Day
Year
Date
YEAR
Rank
Please Select
Envoy
Cadet
Lieutenant
A/Captain
Captain
Major
Lieutenant Colonel
Commissioner
Colonel
Rank / Title
Last Name
First Name
Email
example@example.com
Assignment Location
Please Select
AK DHQ
ARCC
Albany Corps
Baker City Service Center
Bend Corps
Boise Corps
Bridgeway of Hope
Caldwell Corps
Camp Kuratli
CFOT
Coos Bay Corps
CS DHQ
DO
Grants Pass Corps
Gresham Corps
GS DHQ
HI
Hope Center
Idaho Falls Corps
Idaho Service Center
IM
Klamath Falls Service Center
LaGrande Service Center
Medford Citadel Corps
Moore Street Corps
Nampa Idaho Corps
Newport Corps
NW DHQ
Pendleton Corps
Pocatello Outpost
Portland Tabernacle Corps
Roseburg Corps
SAFES (Female Emergency Center)
Salem Kroc Corps & Community Center
SC DHQ
South Willamette Valley Corps
Sunderland RV Safe Park
SW
The Dalles Service Center
THQ
Twin Falls Service Center
Veterans & Family Center
West Women's & Children Center
Yamhill Service Center
Commission Date
-
Month
-
Day
Year
Date
#Days
#Adj
#Total
Calculated Total Day
Appointment Date
Furlough Dates
Start Date
/
Month
/
Day
Year
1
End Date
-
Month
-
Day
Year
2
#Days
Emergency Contact
Name & Phone
Cruise? (Y or N) If yes, list cruise line
Start Date
-
Month
-
Day
Year
3
End Date
-
Month
-
Day
Year
4
#Days
Emergency Contact
Name & Phone
Cruise? (Y or N) If yes, list cruise line
Start Date
-
Month
-
Day
Year
5
End Date
-
Month
-
Day
Year
6
#Days
Emergency Contact
Name & Phone
Cruise? (Y or N) If yes, list cruise line
Start Date
-
Month
-
Day
Year
7
End Date
-
Month
-
Day
Year
8
#Days
Emergency Contact
Name & Phone
Cruise? (Y or N) If yes, list cruise line
Start Date
-
Month
-
Day
Year
9
End Date
-
Month
-
Day
Year
10
#Days
Emergency Contact
Name & Phone
Cruise? (Y or N) If yes, list cruise line
Start Date
-
Month
-
Day
Year
11
End Date
-
Month
-
Day
Year
12
#Days
Emergency Contact
Name & Phone
Cruise? (Y or N) If yes, list cruise line
Start Date
-
Month
-
Day
Year
13
End Date
-
Month
-
Day
Year
14
#Days
Emergency Contact
Name & Phone
Cruise? (Y or N) If yes, list cruise line
Start Date
-
Month
-
Day
Year
15
End Date
-
Month
-
Day
Year
16
#Days
Emergency Contact
Name & Phone
Cruise? (Y or N) If yes, list cruise line
Start Date
-
Month
-
Day
Year
17
End Date
-
Month
-
Day
Year
18
#Days
Emergency Contact
Name & Phone
Cruise? (Y or N) If yes, list cruise line
Start Date
-
Month
-
Day
Year
19
End Date
-
Month
-
Day
Year
20
#Days
Emergency Contact
Name & Phone
Cruise? (Y or N) If yes, list cruise line
Days Used to Date
Balance
Furlough Request Forms
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