• Unpaid Time Off Request

    Submit your request for unpaid time off. All requests will be reviewed by your manager or HR.
  • Format: (000) 000-0000.
  • Type of Leave Requested*
  • Start Date of Unpaid Leave*
     - -
  • End Date of Unpaid Leave*
     - -
  • Should be Empty:
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\n \"Jotform<\/td>\n <\/tr>
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{form_title}<\/h3>\n <\/td>\n

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\n Full Name\n <\/td>\n \n {q2_fullname0}\n <\/td>\n <\/tr>
\n Employee ID\n <\/td>\n \n {q3_textbox1}\n <\/td>\n <\/tr>
\n Email Address\n <\/td>\n \n {q4_email2}\n <\/td>\n <\/tr>
\n Phone Number\n <\/td>\n \n {q5_phone3}\n <\/td>\n <\/tr>
\n Store Location \/ Department\n <\/td>\n \n {q6_textbox4}\n <\/td>\n <\/tr>
\n Job Title\n <\/td>\n \n {q7_textbox5}\n <\/td>\n <\/tr>
\n Type of Leave Requested\n <\/td>\n \n {q8_radio6}\n <\/td>\n <\/tr>
\n Start Date of Unpaid Leave\n <\/td>\n \n {q9_datetime7}\n <\/td>\n <\/tr>
\n End Date of Unpaid Leave\n <\/td>\n \n {q10_datetime8}\n <\/td>\n <\/tr>
\n Total Number of Days Requested\n <\/td>\n \n {q11_number9}\n <\/td>\n <\/tr>
\n Reason for Unpaid Leave\n <\/td>\n \n {q12_textarea10}\n <\/td>\n <\/tr>
\n Supervisor\/Manager Name\n <\/td>\n \n {q13_textbox11}\n <\/td>\n <\/tr>
\n Additional Comments or Information (optional)\n <\/td>\n \n {q14_textarea12}\n <\/td>\n <\/tr>
\n I acknowledge that this request is for unpaid time off and understand the impact on my compensation.\n <\/td>\n \n {q15_checkbox13}\n <\/td>\n <\/tr><\/tbody><\/table><\/td>\n <\/td>\n <\/tr>
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<\/td>\n \n You can {edit_submission}<\/span> and {all_submissions}<\/span> easily.\n <\/td>\n <\/td>\n <\/tr>
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<\/td>\n <\/tr><\/tbody><\/table><\/div>\n \n <\/body><\/html>\n","bodyRevised":"0","branding21Email":"1","dirty":"","dirtyEmail":"0","from":"{q2_fullname0}","hideEmptyFields":"1","html":"1","lastQuestionID":"1","name":"Notification 1","newDisableFlow":"1","pdfattachment":"","replyTo":"{q4_email2}","sendOnEdit":"1","sendOnSubmit":"1","subject":"Re: {form_title} - {q2_fullname0}","to":"template+laurelwood@jotform.com","type":"notification","uniqueID":"260862433511048","uploadAttachment":""},{"aiEditedEmail":"0","aiGeneratedEmail":"0","attachment":"","body":"\n