Time Off Requests Time Off Request Name(Required) First Last Email(Required) Phone(Required)Note: Please Request all times within a week (Sunday to Saturday). Please submit following weeks on another form.(Required) I understand. If “Amount PTO Requested” field is left blank or not completed, accrued time will NOT be used. If the request is under 2 weeks, PTO MAY NOT be approved. Explanation below required if less than 2 weeks.Date Requested(Required) MM slash DD slash YYYY Amount PTO RequestedPlease enter a number less than or equal to 8.00.Date MM slash DD slash YYYY Amount PTO RequestedDate MM slash DD slash YYYY Amount PTO RequestedDate MM slash DD slash YYYY Amount PTO RequestedDate MM slash DD slash YYYY Amount PTO RequestedDate MM slash DD slash YYYY Amount PTO RequestedDate MM slash DD slash YYYY Amount PTO RequestedI acknowledge that "IF" this Schedule Request is not within the requested two weeks notice, my PTO may be denied "AND" I will call the office immediately after submitting. (Short Notices need to be reported to Office Administration for Scheduling Purposes) I understand and will call 859-303-4040 after submitting if less than 2 week notice. Call immediately – If after hours, call and press 0 to speak with the on call manager. Leave Voicemail if not answered.HiddenTotal Hours RequestedExplanation if needed