Time-off Request Form

Please use this form to request time-off for approval, or request for sick leave to be paid.

Name

First Name

Last Name

Today's Date

YYYY

Choose One

Paid Sick Leave

Paid Time Off

Unpaid Time Off

Dates of Requested Leave

One More Step!

Let us know if you'd like a specific number of hours used for PTO/Sick Leave, or if you'd like to use your max amount of PTO available. Any other info is always welcome :)

Time-off Request Form

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