PW Employee Time Off Request

Time Off Request Form
Name*

First NameLast Name
Todays Date

MonthDayYear
Email*
***Reminder: Time off requests must be made 2 weeks out***
First Day Of Leave*

MonthDayYear
Date
Hour MinutesAM/PM Option
Last Day Of Leave*

MonthDayYear
Date of last day off/ Return to work next day
AM/PM Option
Time-Off Start Date & Time
Time-Off End Date & Time
Reason For Time Off Request*
Time off Request is:

PENDINGAPPROVEDDENIED
Reason Request Was Denied
Approved By
Should be Empty:

Time Off Request Form