Request for Time Off Please enable JavaScript in your browser to complete this form.Name *FirstLastEmployee # *Reason for Time Off *VacationMedical AppointmentIllness – SelfIllness in FamilyPersonalBereavementJury DutyOtherIf Other, ExplainPaid or Unpaid (Note: Non-union employees must exhaust all paid leave prior to requesting unpaid leave.) *PaidUnpaidDate(s) Requested to be Off Work (if half day, indicate a.m. or p.m.) *Submit