Employee Request form

Employee Request Form

TODAY'S DATE

NAME

First

Last

ARRIVING LATE OR NEED TO LEAVE EARLY REQUEST

ARRIVE LATE (ENTER TIME BELOW)

LEAVE EARLY (ENTER TIME BELOW)

Time

PLEASE ENTER REASON FOR ARRIVING LATE / LEAVING EARLY

DAYOFF REQUEST

DAY OFF

ENTER DURATION (IN HOURS OR DAYS)

START DATE

END DATE

PLEASE ENTER REASON FOR REQUEST FOR DAY OFF

I HEREBY APPEAL THE FOLLOWING VIOLATION

DATE OF VIOLATION

VIOLATION WRITTEN BY:

PLEASE ENTER REASON FOR APPEAL

EMPLOYEE SIGNATURE

I HEREBY REQUEST AN HUMAN RESOURCE MEETING

PLEASE ENTER A BRIEF REASON FOR THE MEETING

I HEREBY REQUEST TO CASH OUT THE FOLLOWING

PLEASE ENTER THE NUMBER OF HOURS AND FROM WHAT PAY PERIOD

Signature

If you are human, leave this field blank.