Name(Required) First Last Email(Required) Enter Email Confirm Email Today's Date MM slash DD slash YYYY Time Off Amount (Days or Hours)Time Off Type(Required) Days Hours Time off Beginning on:(Required) MM slash DD slash YYYY Time off Ending on:(Required) MM slash DD slash YYYY Reason for Request(Required)VacationPersonalSickBereavementJury DutyMedicalTo VoteConsent(Required) I understand that my request is subject to approval by my employerEnter name as digital signature(Required)