Time Off Request - Hourly Staff
Please complete the below fields to request time off. Your Manager will review and approve/decline the request based on if the hours requested below are still available in your PTO bank. If you receive a rejection for for paid time off, please review the response and resubmit accordingly.

Please note - all time off requests must still be submitted through Square, this form is only if you are eligible for paid time off as a full-time employee (working annually more than 34 hours per week on average).
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Email *
Name *
Enter your first and last name below.
Verify Email *
Verify the e-mail above, a copy of this form will be sent here.
Current Paid Time Off *
Enter the amount of Paid Time Off according to your most recent pay stub. This is to help your manager to determine if you have enough PTO in your PTIO Bank to cover the request below.
Paid or Unpaid *
You should always select "Paid" - this question is only to accurately fill in the created document after submission.
Beginning Date *
Enter the first day your Paid Time Off Request begins.
MM
/
DD
/
YYYY
End Date *
Enter the last day of your paid time off request - note, if you are requested 8 hours or less, this should be the same date as "Beginning Date."
MM
/
DD
/
YYYY
Total Hours Requested *
Enter the total number of hours you would to receive paid time off for. Note, this cannot exceed 40 hours per week. If you are working during the week, the total hours cannot exceed 40 hours. I.E. you work 1 day of 9.5 hours, you are only eligible for 30.5 hours of PTO for the rest of that same week.
Additional Information
Provide any additional information you feel is relevant
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