Time Off Request Form
Today's Date:
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Month
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Day
Year
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Employee Name:
*
Please Select
Austin Lopp
Cal Winn
Carter Ferryman
Chris Allred
Erik Wogen
Fran Zankowski
Holden Hauke
Jezy Gray
Kaylee Harter
Kellie Robinson
Mark Goodman
Mari Nevar
Matthew Fischer
Shay Castle
Stewart Sallo
Will Matuska
M
Email Address:
*
Start Date:
*
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Month
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Day
Year
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:
Hour
00
10
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30
40
50
Minutes
AM
PM
AM/PM Option
End Date:
*
-
Month
-
Day
Year
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1
2
3
4
5
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10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Total Hours:
*
PAID or UNPAID:
*
Paid
Unpaid
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