Time Off Request Form

1
Your Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Department* This field is required.select which department your are currently serving
Please Select
Please Select
Team Director
OKC - Administration / Finance Team
OKC - Infrastructure Systems Team
OKC - Managed Services & Computer Networking Team
OKC - Voice Services Team
VIP - Administration / Finance Team
VIP - Infrastructure Systems Team
VIP - Managed Services & Computer Networking Team
VIP - Voice Services Technicians
VIP - Voice Services Administration
4
Time Off Start Date* This field is required.
Date
Month
Day
Year
5
Time Off End Date* This field is required.
Date
Month
Day
Year
6
Total Hours of Time Off Requested* This field is required.Number of business hours that will be accounted for in the requested time off; Example: 12 hours
7
Start Time of PTO RequestedIf less than a full 8 hour day, exact start time of PTO is required
1
2
3
4
5
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8
9
10
11
12
Hour
00
10
20
30
40
50
Minutes
PM
AM
PM
8
Finish Time of PTO RequestedIf less than a full 8 hour day, exact end time of PTO is required
1
2
3
4
5
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10
11
12
Hour
00
10
20
30
40
50
Minutes
PM
AM
PM
9
Type of Time Off Requested* This field is required.Select One
Paid Time Off
Unpaid Time Off
10
Additional CommentsUse this box to provide any communication deemed necessary to complete this request.
11
SignatureIf you are not able to digitally sign this form, by selecting the 'SUBMIT BUTTON' below, you are aware and confirm this form gives permission to the company you are requesting PTO from to deduct this time from your annual allotment of PTO, if approved.
Should be Empty: