Request Time Off
Name
*
First Name
Last Name
Email
*
example@example.com
I understand that:
*
• All requests are granted on a first come, first serve basis.
• All requests should be submitted at least two weeks prior to the requested dates.
• Requests off submitted less than 2 weeks prior will be considered a call off and may affect Bonus Eligibility for the quarter.
• Every effort will be made to grant time off requests; in some circumstances, in order to provide consistent services to our clients, we may only be able to grant time off to the employees who submit their requests first.
• If you are requesting paid time off, please put the number of paid hours in the notes section.
• Paid time off is paid 8 hours per day off and may not be used as overtime hours.
Time Off Begins
*
/
Month
/
Day
Year
Date
Time Off Ends
*
/
Month
/
Day
Year
Date
Return to Work
*
/
Month
/
Day
Year
Date
Purpose:
*
Paid Time Off
Sick Leave
Personal Leave
Jury Duty
Funeral/Reprieve
Other
Please put the number of paid hours in the section below. Sarah will let you know if you will be granted these hours. Paid time off is paid 8 hours per day off and may not be used as overtime hours.
Submit
Should be Empty: