Vacation_Request_Form

MEMBER INFORMATION:

(* = required field)

First Name*:

Middle Initial:

Last Name*:

Suffix (e.g. Jr, III, etc):

Primary Telephone*:

Delivery Address*:

City*:

Select Bozrah Baltic East Lyme Gales Ferry Griswold Groton Hadlyme Ledyard Lisbon Lyme Montville Mystic New London Niantic North Stonington Norwich Oakdale Old Lyme Old Mystic Old Saybrook Pawcatuck Preston Quaker Hill Salem South Lyme Sprague Stonington Taftville Uncasville Waterford West Mystic Westerly

State*:

CT NY RI

Zip Code*:

Select 02891 06320 06330 06333 06334 06335 06339 06340 06351 06353 06355 06357 06359 06360 06365 06370 06371 06372 06375 06376 06378 06379 06380 06382 06385 06388 06420 06439 06475

Email Address*:

Note: Email is a required field to confirm receipt of your vacation request.

VACATION REQUEST:

The following are our deadlines for submitting a stop on your paper: Mon-Wed - 2:30 p.m. for next day or later Thurs- 2:00 p.m. for next day or later Fri - 2:00 p.m. for Sat.- Mon. or later Stops submitted over the weekend will not take affect until Tuesday of following week. Holiday deadlines are specialized as they occur, but generally, please submit your stop at least two business days before the holiday.

Temporary Stop Date: (enter as: MM/DD/YYYY)

Restart Date: (enter as: MM/DD/YYYY)

Vacation Hold Options:

Select Credit account Hold & Redeliver Upon Return Donate to Newspapers in Education

Comments: