Time Off Request
Our new PTO policy requires this form to be completed for any planned absence at least two weeks in advance. PTO will be granted in half-hour increments only provided there is PTO available.
Name
*
First Name
Last Name
Email to receive a copy of request:
example@example.com
Complete this section for full day(s) off:
Please list all of the days that you plan to be absent:
Total Number of Days:
Complete this section if you need a partial day off:
List the date and time you need to arrive late for your shift:
List the date and time you need to leave early:
Reason for Request
Please indicate the reason for your request:
*
Medical Appointment
Personal
Additional Vacation Time
Child's School Activity
Funeral/Bereavement
Jury Duty
Other
With my signature, I understand that my request may not be approved if I do not have PTO available, if two staff members have already requested the same day, there are special events being held at the school, or I do not submit this request in a timely manner.
*
Submit
Should be Empty: