Time Off/Additional Hours Request

When requesting up to two days off, a time off request must be submitted and approved no later than 48 hours prior to the start of the requested absence. For requests in excess of two days, a time off request must be submitted and approved no later than two weeks prior to the first day of the requested time off. Approvals for each request will be given in writing to the employee as a response to the submitted online Time Off/Additional Hours Request form. A valid email must be entered on this form when it is submitted in order to receive the approval. Time off requests for one day or less, employees may also request the hours to be rescheduled/exchanged for another shift in the same week.

You may also use this form to indicate that you are available to work additional hours, or to cover additional shifts.  This form is not to be used to request overtime.

    Time Off Request


    Dates of Requested Time Off


    Shift Exchange

    If possible, I would like to switch the following shifts:
    (For example, I work Wednesday and have Monday off. Switch to work Monday and have Wednesday off.)

    From Date
    To Date

    I understand submission of this form is only a request and is subject to written approval from management. I have entered a valid email address to receive my approval/denial of my request. I also understand that until I receive written approval, I am responsible and expected to adhere to my current schedule.

    Additional Hours Request

    List days and times that you are available.

    Submit completed report to management

    Employee Name (required)

    Email (required)