Time Off Request Form
TIME OFF REQUEST FORMPlease submit this form for approval at least four (4) weeks in advance of your preferred vacation dates. All requests should first be verbally submitted to your supervisor in person; forms can then be submitted via email or in person after this initial conversation. Vacation time that is not approved but still taken by the employee will be unpaid and subject to progressive discipline.Date: _____________________________________________________________Employee Name: ____________________________________________________Vacation Dates Requested: ____/____/______ through ____/____/______Returning: ____/____/______Total Number of Days/Hours Requested: ____________________________________________________________________?__________________________Signature of Employee?Request DateApproval (circle one):?YES?NO__________________________________?__________________________Supervisor Name?Approval or Denial DateFOR INTERNAL USE ONLY:Recorded into Employee Calendar:?YES?NORecorded into Payroll System:?YES?NO ................
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