PTO FORM

Important - Please Read:

By submitting this form, you are notifying Human Resources and the Office Manager, only, of your PTO request. In addition to submitting this form, you must notify your supervisor(s) separately of any and all time you schedule out of the office.

Name *
Name
Please Check One: *
Date 1
Date 1
Date 2
Date 2
Date 3
Date 3
Date 4
Date 4
Date 5
Date 5
Please DO NOT include personal details or medical information. If further explanation is needed, we will contact you.