Time Off Request Form Date MM slash DD slash YYYY Email Name First Last Time off start date(Required) MM slash DD slash YYYY Return to work date(Required) MM slash DD slash YYYY Class of Time off Requested(Required)PTOSick LeaveOSL (Oregon Sick Leave)Days or Hours(Required)Days OffHours OffNumber of PTO Hours/Days (If no PTO enter 0)(Required) Reason for Leave(Required)VacationPersonal LeaveFuneral/BereavementJury DutyFamily LeaveMedical LeaveVoteOther See Comments sectionComments Section Δ
