Time Off Request Form

To learn more about our Time Off Policy, click here. Once you have submitted your request, your director will be in contact to follow up. Friendly reminder that submitting the request form does not automatically mean it is approved. We strongly recommend you wait to make plans until your director follows up on the request.

Today's Date

YYYY

Name

First Name

Last Name

Date of Vacation:

Number of Vacation Hours Being Used:

Name and Date of Director approving request

Time Off Request Form

Moore Chicken