TIME OFF REQUEST FORM

Each employee must submit this request form to his/her manager at least five (5) working days prior to the "planned" day(s) off. Requested time off is subject to manager's approval, and priority is given on a "First Come First Serve Basis".

Employee Name:

Your E-mail Account:

Send To:

Date Submitted:

REQUEST

SCHEDULED AND UNSCHEDULED

If you have not yet accrued or have used all of your PAID TIME OFF, you may request UNPAID TIME OFF. This is subject to management approval.

Please fill out all areas that apply to your request. Any incomplete forms will be sent back. Your cooperation is appreciated

Number of hour(s) requested:

Please indicate time-off type:

Date(s) Requested (Please indicate month, day and year)

From:
To:

Reason for request: