YDLV Time Off Request
Please complete this form to submit your time-off request. You will be notified whether your request is approved or denied. If approved, please arrange coverage and notify the administrative and office staff who will be covering for you.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Type of Leave
*
Please Select
Vacation
Personal Leave
Other
Other Type of Leave
*
Start Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
End Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Leave
Signature
*
Submit Request
Should be Empty: