PTO · GridTally

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Employee Info

Employee Name

Date Submitted

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Type of Time Off

🏖️ Vacation

🤒 Personal / Sick

🕊️ Bereavement

⚖️ Jury Duty

💸 Unpaid Leave

📌 Other

Please select a type of leave.

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Period of Absence

From Date *

Please select a start date.

To Date *

Please select an end date.

Returning to Work

Total Working Days 0 days (0 hrs)

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Additional Notes

I acknowledge that this request is subject to management approval and operational requirements. I understand vacation requests require 2 weeks notice when possible.

Please acknowledge the terms above.

GridTally

Access Pending

Access Denied

Time Off Request

Employee Info

Type of Time Off

Period of Absence

Additional Notes

Review Before Submitting

Request submitted