Leave Request Page

This page is for current employees only

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Name(Required)

First Last

Email(Required)

Employment Type(Required)

Salary or Hourly Full/Part Time

Job Title(Required)

Type of Leave(Required)

Sick, Vacation, Maternity/Paternity, Partial Day, Half Day, Work from Home

Paid Time Off or Non Paid Time Off(Required)

PTO

Non-PTO

Total Number of PTO hours to be Used(Required)

Please enter a number greater than or equal to 0.

eg. If gone for three days but only want PTO for two put 16

Beginning Date of Leave(Required)

Note Sat/Sun At End of Week

End Date of Leave(Required)

Note Sat/Sun At End of Week

Send Request To:(Required)

Must Include Supervisor Select All That Apply

Melinda

James

Joe

David

Test (only sends to Gohar)

Phone

This field is for validation purposes and should be left unchanged.