Time Off Request Form

( * Required Field )

Name *
Name
Date Requested off OR first day of multi-day request: *
Date Requested off OR first day of multi-day request:
Date you will be returning to work: *
Date you will be returning to work:
Time requested: *
(Please include hours needed if you only need off half days)
I understand that I am not guaranteed these dates off. The time off will be considered to be approved when the employee receives email back from supervisor or business office with approval.
Todays Date: *
Todays Date: