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Time Off Request Form
Time Off Request Form
Name:
Number of days requested:
Starting on:
Ending on:
Return to work date:
Who will need to be notified?
Request Type:
Paid Time Off
Unpaid Time Off
Funeral / Bereavement
Other (please specify below)
**Fill out if using more than one category
*Paid time off to be used (hours):
*Unpaid time to be taken (hours):
Email:
Notes:
Submit