Employee Name
*
First Name
Last Name
Email
*
example@example.com
Date Request Submitted
-
Year
-
Month
Day
Date
Employee's Manager
*
Manager's Email
*
example@example.com
Time off Dates, Total hours requested
*
PLEASE LIST A BRIEF EXPLANATION TO THE REASON FOR TIME OFF
Time off Type
PTO
Unpaid
Maternity
Has your manager been notified / approved this request?
YES
NO
Employee Signature
Submit
Should be Empty: