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Time Off Request
Employee Name
(Required)
Supervisor
(Required)
Lilly
Jill
John
Christine
Brent
Britney
Category of Time Off
(Required)
Please select
Vacation / Personal (PTO)
Paid Volunteer Time
Date off
MM slash DD slash YYYY
First Leave Day
MM slash DD slash YYYY
Last Leave Day
MM slash DD slash YYYY
Total Volunteer Hours to be used
Total Working Days Off
(Required)
Total Hours Off
(Required)
What is your available PTO balance?
(Required)
How many vacation hours will be PTO?
Will any of this time off be unpaid?
(Required)
Employee Notes
