Time Off Request Form

Paid Time Off Request

Requests must be approved by both the GM & Supervisor. Store coverage is necessary for any & all requests to be approved. PTO will be denied if the employee calls off the day before or day after requested time.
Store Name*
Job Title*
Employee Name*

First NameLast Name
E-mail*
example@example.com
Contact Number*
PTO Start Date*

MonthDayYear
Date
PTO End Date*

MonthDayYear
Date
Back to Work Date*

MonthDayYear
Date
# PTO hours *
Reason*
Additional Comments
Should be Empty:

Paid Time Off Request