New Mexico Administrative Code
Title 9 - HUMAN RIGHTS
Chapter 4 - PERSONS WITH DISABILITIES
Part 7 - BUSINESS ENTERPRISE PROGRAM PROCEDURES MANUAL FOR BLIND VENDORS
Section 9.4.7.24 - APPENDIX 13: COMMISSION FOR THE BLIND BUSINESS ENTERPRISE PROGRAM
Universal Citation: 9 NM Admin Code 9.4.7.24
Current through Register Vol. 35, No. 18, September 24, 2024
APPLICATION FOR LEAVE
Licensed Manager Name:___________________ Facility No.______
Date________
________________________________________________________________________________________
Type of Leave:
_____ ANNUAL START DATE______ ENDING DATE_____TOTAL HOURS_____
_____*SICK START DATE______ ENDING DATE_____TOTAL HOURS_____
TOTAL HOURS ____
________________________________________________________________________________________
____________________________ ____________________________
Licensed Mgr. Signature Date BEP Manager Signature Date
*Any request for five days or more of sick leave must be accompanied by a release form from the doctor.
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