PAID TIME OFF REQUEST FORM
Employee Name
*
First Name
Last Name
Employee Email
*
example@example.com
Manager Name
*
First Name
Last Name
Manager Email
ajacobsen@allentownsymphony.org
kkiernan@allentownsymphony.org
ahaag@allentownsymphony.org
lbeneyton@allentownsymphony.org
gharrington@allentownsymphony.org
deddinger@allentownsymphony.org
jkent@allentownsymphony.org
Other
Manager Email
*
example@example.com
Date From:
*
-
Month
-
Day
Year
Date
Date To:
*
-
Month
-
Day
Year
Date
Please click here if you are requesting a half day off
Half Day
Type of time off
*
PTO
Comp Time
Breavement
Jury Duty
Unpaid Leave
What is the best way to reach you while away? (Please select all options that apply)
*
Phone
Text
Email
I am unreachable
Phone Number you can be reached at:
Notes (if needed):
Signature
*
Submit
Should be Empty: