Time Off Request

Request for time off work. Submission does not guarantee the time off. That must be approved by your Supervisor. Submission does not guarantee payment, unless you have enough hours to cover it.

MM slash DD slash YYYY
Name
MM slash DD slash YYYY
MM slash DD slash YYYY
If available, would you like to be paid for this time off?
If you would like to be paid for less than 8 hours, please indicate the number of hours
If you are only needing off part of a day for an appointment, please indicate the time you will need to be off (i.e. 9a-12p)