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Time Off Request

Fill out the form below to request time off. You will be notified via email when your request has been approved.

Name*
First Last
Your Preferred Email Address*
Today's Date
Date Format: MM slash DD slash YYYY
First Day of Leave
Date Format: MM slash DD slash YYYY
Last Day of Leave
Date Format: MM slash DD slash YYYY
Leave Early Date
Date Format: MM slash DD slash YYYY
Time

: HH

MM
In Late Date
Date Format: MM slash DD slash YYYY
Time

: HH

MM
Type of Leave*
Total Number of Workdays (one full workday or more)
Total Number of Hours (less than one full workday)
Additional Information

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