Time Off Request Form

Time Off Request
First Name*
Last Name*
Email*
example@example.com
Date From:

MonthDayYear
Date
Hour MinutesAM/PM Option
Date To:*

MonthDayYear
Date
Hour MinutesAM/PM Option
Type of time off*

VacationPersonalJury DutyOther
Do you want to use PTO for these days?*

YesNo
If Yes, how much PTO would you like submitted?
Comments
Should be Empty: