TIME OFF / CASH OUT REQUEST FORM

Today's Date
Team Member Name *
Supervisor Name *
This request form must be submitted a minimum of 72 hours for individual days; a minimum of 30-days before anticipated vacation of 5 days or more to receive preferential consideration. All requests must be pre-approved by a Supervisor.
# Of Hours To Be Cashed Out: (up to 80 hours per year)
12 months of employment required. Request must be submitted by end of the 1st full week in December.