Time Off Request Form
Fields marked with an* are required. If we are not told to use PTO we will not use it. Note: Sick time is for sick time only.
Employee Name
*
First Name
Last Name
Day/Dates Requested
*
Use PTO?
*
Yes
No
Type of Day Off Requested
*
Vacation
Day Off
PTO
Sick Day
Supervisors Name
*
Notes
Submit
Should be Empty: