Time Off Request - Environmental Alternatives LLC

P: 301.428.0822
F: 240.403.1121

P: 301.428.0822
F: 240.403.1121

Time Off Request and Approval

Name*
First Middle Last
Email*
Employee / Payroll #*
Department*
Employee Hire / Service Date*
Date Format: MM slash DD slash YYYY
Status*
- Full Time
- Part Time
Select Your Dates
Select the first day and last day of your time off request below.
First Day of Request*
Date Format: MM slash DD slash YYYY
Last Day of Request*
Date Format: MM slash DD slash YYYY
Does this date range include a legal public holiday?*
- Yes
- No
(See public holidays list to the right)
Reason For Request
Choose One:*
- PTO
- No Pay
- Bereavement
- Leave w/out pay
- Cancellation
Select the type of time off you'd like to use.
Comments
Signature*

Legal Public Holidays

If you are requesting a range of dates that includes one of these holidays, please let us know in the form on the left.

January

1 – New Year's Day
15 – Martin Luther King Jr. Day

February

12
14
14
19
19

March

17
25
30
30-7

April

1 Easter Sunday

May

Mother's Day
Armed Forces Day
Memorial Day

June

Flag Day
Father's Day

July

4 – Independence Day

September

3 – Labor Day
9-11 – Rosh Hashanah
18-19 – Yom Kippur

October

Columbus Day
Halloween

November

Election Day
Veterans Day
Veterans Day (Observed)
Thanksgiving Day

December

Hanukkah
Christmas Day
New Year's Eve

© Environmental Alternatives, LLC.
Roll-Off and Recycling Services
Phone: 301.428.0822
Fax: 301.428.1736
Email: dispatch@eairolloff.com
24024 Frederick Rd, Clarksburg, MD 20871

Equal Opportunity Employer

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