Time Off Request – EAI – Environmental Alternatives

301.428.0822

dispatch@eairolloff.com

24024 Frederick Rd, Clarksburg, MD 20871

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301-428-0822

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.
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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.