Request for Time Off

Request for Time Off

Employee Name

First Name

Last Name

Email

Please select the option that applies to you:

Start Date

MM

DD

YYYY

End Date

MM

DD

YYYY

Time

Hour

Minute

Second

PLEASE NOTE:

Requests to leave early on the day of work must accompany proof of reason for leaving early.
Requests for 4 or less days off must be submitted at least 14 days in advance.
Requests for 5 or more days off must be submitted at least 30 days in advance.
With valid proof, the following reasons do not require advance notice: Jury Duty, Bereavement and Military Leave.
If you will only be requesting 1 day off, please enter the same Start and End dates.
All (paid) time off must be approved by office.