Vacation Request Form

"*" indicates required fields

All employees seeking to use vacation time must complete and submit a vacation request form. The number of vacation days requested, along with the beginning and end dates of the vacation are required. It is protocol for all vacation request forms to be submitted for processing and approval no later than two (2) full weeks before the stated start date of the requested vacation period. Requests submitted within two (2) full weeks of the start date will be considered on a case-by-case basis and may not be approved. Department supervisors will also be notified when vacation time is approved by HR.

NOTE: No vacation leave shall be granted without proper submission of this form within two (2) weeks prior to the begin date of the requested vacation period. Failure to submit a request at all will result in no pay and a written warning.

Name*

First Last

Email*

This is the email address where you will receive a notification when your request is approved or denied.

Department*

Select Dates

Single Date	Range start date	Range end date	Number of days	Actions

There are no Dates.

Total number of days requested

The number of days requested may show incorrectly - there is a known website plugin issue happening. It will be corrected soon, but for now please double check the number of days and write a note if it's incorrect. Thanks!

Notes

Name

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