Sick Time and Paid Time Off Requests

Form filled out Date and time
Employee Information
First Name*
Last Name*
Email*
Request for the following hours off:
Date*
Date Format: MM slash DD slash YYYY
Hours*
Departments*
Please select ALL the departments that will be impacted if this request is approved.
This time off request is for:*
Untitled
Please provide a brief explanation for your time off request.
Additional Days
Would you like to request an additional day(s)?
- Yes
Date*
Date Format: MM slash DD slash YYYY
Hours*
Date Format: MM slash DD slash YYYY
Date Format: MM slash DD slash YYYY
Date Format: MM slash DD slash YYYY
Date Format: MM slash DD slash YYYY
Date Format: MM slash DD slash YYYY
Total Hours Requested
Total number of hours requested
Documentation Upload
Drop files here or
Please provide documentation necessary and relevant to this request.

Employee Information