Employee Time Off Request

Employee Name *

Today's Date * +

Which location(s) will you be requesting dates off for? *

Office Staff - Have you communicated necessary notes to team members who are covering your shift/s? Instructors - Have you communicated any necessary notes in your students Practice Journal or detailed instructions for Guest Instructors to be aware of? *

Yes

No, but I am aware I must complete this task before I leave for vacation.

Days requested

Vacation start date
(must be a minimum of a month from today) * +

Vacation end date * +

If you are requesting time off within 30 days, you will need to cover your shift(s) at whichever location(s) you are requesting time off for.

Who is covering your shift(s)? Please enter the name(s) and the date(s) they will be covering. *

Comments

I understand this request is subject to approval by management. *

Yes, I understand this is only a request and is not automatically approved

Employee Signature *

clear