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CNE Time Off Confirmation Form

Name*
First Last
Email*
My Supervisor is:*
Your supervisor will be notified via email after submission of this form. They will notify you with approval PTO hours used for official record.
Reason for Time Off*
- PTO
- Parental Leave
- Bereavement Leave
- Jury Duty
- Voting
Please see Employee Handbook for all types of leave.
Actual Leave Start Date*
MM slash DD slash YYYY
Actual Leave End Date*
MM slash DD slash YYYY
Total Requested PTO Hours*
Total Used PTO Hours*
Comments