Time Off Requests Time Off Request This field is hidden when viewing the formDate YYYY dot MM dot DD Name(Required) First Last Email(Required) Phone(Required)Note: Please Request all times within 1 week (Sunday to Saturday). Please submit any other weeks on seperate forms.(Required) I understand. IF “Amount PTO” field is left blank , 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. If more than a week submitted, PTO may not be credited on payroll and you may be asked to resubmit.Sunday – Date MM slash DD slash YYYY Amount PTO – SundayPlease enter a number less than or equal to 8.Monday – Date MM slash DD slash YYYY Amount PTO – MondayPlease enter a number less than or equal to 8.Tuesday – Date MM slash DD slash YYYY Amount PTO – TuesdayPlease enter a number less than or equal to 8.Wednesday – Date MM slash DD slash YYYY Amount PTO – WednesdayPlease enter a number less than or equal to 8.Thursday – Date MM slash DD slash YYYY Amount PTO – ThursdayPlease enter a number less than or equal to 8.Friday – Date MM slash DD slash YYYY Amount PTO – FridayPlease enter a number less than or equal to 8.Saturday – Date MM slash DD slash YYYY Amount PTO – SaturdayPlease enter a number less than or equal to 8.This field is hidden when viewing the formTotal Hours RequestedI acknowledge that "IF" this Schedule Request is less than 2 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)(Required) 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.Explanation if neededWhy needed and why if less than 2 weeks.CAPTCHA