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PTO Request

THIS IS A REQUEST. PLEASE WAIT FOR CONFIRMATION AFTER SUBMITING.

This form allows employees of Pothole Repair to apply for PTO in advance.
Please do not use this form for unplanned PTO.

•    Time-off requests should be submitted 14 days in advance.
•    Time off requests for jury duty or birth of child must be submitted at least 30 days in advance.
•    Time off requests may be approved / denied at the manager’s discretion. Approval / denial will be based on prior requests from yourself and other employees and available coverage.
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Email *
Name *
What department do you belong to?
 *
What yard are you assigned to? (For technicians and surveyors)
 *
Who is your manager?
 *
First day you are requesting off *
MM
/
DD
/
YYYY
Day you will resume work
 *
MM
/
DD
/
YYYY
Reason for requesting time off *
A copy of your responses will be emailed to the address you provided.
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