WPB Novopharm
Time Off Request Form
-
Employee Name
📅
Important: Include Weekends in Your Request
When selecting your dates,
make sure to include Saturdays and Sundays
in your total time off period. The system will automatically calculate the total days including weekends.
Start Date
End Date
❌ End date must be on or after start date. Please correct the dates.
Total Days Out
-
Return to Work Date
-
-
Request Type(s) & Hours
Add one or more request types with their corresponding hours
Select type...
PTO (Paid Time Off)
Vacation
Funeral/Bereavement Leave
Jury Duty
UTO (Unpaid Time Off)
✕
+ Add Another Request Type
⚠️ Hours Exceeds Limit:
Comments
Optional
I understand and acknowledge that this time-off request is subject to management approval and is not guaranteed. I agree to not make any travel arrangements, purchase tickets, or finalize any plans until I receive official written approval from my supervisor. I understand that submitting this form does not constitute approved time off.
Submit Request
Developed by
Julio Maya
© 2025 All rights reserved
