Time Off Request

Time Off Request
Your request for time off must be submitted and approved by management in advance.
Employee Name

First NameLast Name
Employee Email
example@example.com
Number of Days Requested
Starting On

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Return to Work On

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Type of Request (check reason for your request)
Comments
Supervisor
Supervisor Email
example@example.com
By submitting this request, I understand that time away from work is subject to management approval and company policies.
Should be Empty: