Employee Time Off Request Form

Please use the following for to request time off:

Employee Name *

By signing my name, I confirm that I have conferred with the appropriate person(s) to ensure my classroom will be adequately staffed for the duration of my absence.

Email *

We will send an email to this address confirming or denying this request.

I have referred to the calendar in the break room to check for availability. *

Only two staff members may be off simultaneously. If two requests for the same day(s) are made from the same class, the first one submitted will be prioritized.

Initial Date of Absence *

Date

Time

Requests made within two weeks prior to this date may not be approved.

Return Date *

Date

Time

Due to current staffing shortages, requests of more than 5 consecutive working days will not be approved.

Vacation hours used: *

Any earned vacation time must be used before using accrued PTO.

PTO hours used: *

IF you are out of earned/accrued time, you will not be compensated for the requested time off.