Name

Please enter your full name.

Date of Birth

Select your date of birth using the calendar.

Phone Number

Enter your contact number for further inquiries.

Address

Please provide your current mailing address.

Preferred Contact Method

Choose your preferred method of communication.

• Phone

• Email

• Mail

Type of Time Off

Select the type of time off you are requesting.

• Vacation

• Sick Leave

• Personal Day

• Other

Start Date of Absence

Indicate the starting date of your time off.

End Date of Absence

Indicate the last date you will be absent.

Number of Days Requested

Calculate and specify the total number of days you're requesting off.

Reason for Time Off

Provide a brief explanation for your time off request.

Has your manager approved this request?

Confirm whether you have received the necessary approvals.

• Yes

• No

Will you need remote access during your time off?

Indicate if remote access is required during your absence.

• Yes

• No