Request for Time Off

Name *
I request *
on the following date: *
on the following date:
through the following date:
through the following date:
*Only fill in this date if you are requesting a span of 1 or more dates off in a row.
Type of Request: *
I will require coverage for the following: *
Select all that apply.
*Enter 0 if not requesting Personal, Sick, or Vacation time. **One 1 day of work = 8 hours. Hours represent % of day taken off, relative to your work schedule. ex: for a person who works 10am - 2pm, and takes a whole day off, will be using 8 hours of PTO; if they take 10am - 12pm off, that's half a day, and they will be using 4 hours of PTO.