Vacation/ Time off Form
Please give at least 3 weeks notice!
Employees Name
*
First Name
Last Name
Badge Number
Request Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Date Leaving
Date returning
Reason For Request
*
Vacation
Emergency Leave
Time Off
Other
Date able to work?
This will be date your able to work
Expected No. Days
Phone Number
-
Area Code
Phone Number
Officers Signature
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Submit
Back
Next
Save
Approved By
Supervisor
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Submit
Not Approved
Reason for Not Approved
Date
-
Month
-
Day
Year
Date Picker Icon
Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Signature of Employee
To be signed upon receiving the passport
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Submit
Should be Empty: