Overtime Request Form

Harrison CSD Overtime Request Form
All overtime worked must only be completed with prior written approval from the Assistant Superintendent for Business, as recommended by the employee's supervisor.

In the event of an emergency when a request for overtime cannot be pre-approved, this overtime request form must be submitted as soon as practicable after the hours worked, and emergency overtime must be completed at the direction of the immediate supervisor. Emergency overtime is reserved for time-sensitive health and safety situations, to preserve buildings and property, or when weather or other circumstances pose a time-sensitive need
Are You Completing this Form for Yourself or Another Employee?*

I am completing this form to request overtime approval for myselfI am completing this form to request overtime approval for someone else
Name of Employee Completing This Form*

First NameLast Name
Employee Requesting to Work Overtime*

First NameLast Name
E-Mail of Employee Performing Overtime*
example@example.com
Department/Employee Type*

Buildings & Grounds/FacilitiesTechnologyBusiness OfficeSchool SafetyHuman ResourcesCable TVClerical
Position*

CleanerMaintenance ForemanCustodianHead CustodianMaintenance Mechanic/Groundskeeper
Building*

Harrison Avenue ElementaryPurchase ElementaryParsons Memorial ElementaryLMK Middle SchoolPreston ElementaryHarrison High School
Building Office*

HAS Main OfficeLMK Main OfficePAR Main OfficeHHS Main OfficePRES Main OfficeHHS Guidance OfficePUR Main OfficeSpecial Ed OfficeHHS Athletics Office
How many days is this Overtime request for?
Date of Overtime Requested*

MonthDayYear
Date
Approximate Start & End Time*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Total 0.0
Date of Overtime Requested - Day 1*

MonthDayYear
Date
Approximate Start & End Time - Day 1*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Total 0.0
Date of Overtime Requested - Day 2*

MonthDayYear
Date
Approximate Start & End Time - Day 2*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Total 0.0
Date of Overtime Requested - Day 3*

MonthDayYear
Date
Approximate Start & End Time - Day 3*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Total 0.0
Date of Overtime Requested - Day 4*

MonthDayYear
Date
Approximate Start & End Time - Day 4*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Total 0.0
Date of Overtime Requested - Day 5*

MonthDayYear
Date
Approximate Start & End Time - Day 5*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Total 0.0
Brief Description of Work to be Completed (Include info for each day requested)*
Number of Overtime Hours Requested - Day 1*
Number of Overtime Hours Requested - Day 2*
Is this Overtime request for 1 or 2 days? *Note - More than 2 days requires an additional OT request*

1 Day2 Days
Number of Overtime Hours Requested*
Should be Empty: