Time Off Request
Please submit multiple requests if you are planning for different obligations and/or multiple days off excluding vacations or long-term leaves. You are required to give at least 30 days' notice if you are needing a day off, to leave early, or the come later than your scheduled shift. If you are needing more than 2 days off, you are required to give at least 90 days' notice, the most notice you can give is always best. Failure to give the appropriate amount of time request may result in your request being denied. Your request will be approved or denied within 72 hours via email.
Name
*
First Name
Last Name
Email
*
example@example.com
Are you taking off a full day(s) or part of a day?
*
Request entire day off
Request to leave early
Request to start late
What day(s) are you needing off?
*
i.e. 2/4/24 OR 2/4/24-2/6/24
If you are needing to take off part of the day, include what hours you are needing off.
*
i.e. 8:00 AM - 12:00 PM
What is the purpose of your time off request?
*
Vacation
Funeral or Bereavement
Medical Appointment or Leave
Personal Day
Jury Duty
Are you using PTO?
*
Yes
No
What flex days can we open for make up hours? Please list your top 2 choices in the order that works best for you. Paid Vacation Time Off does not need to be made up unless you prefer to.
*
Signature
*
Today's Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: