Employee Time-Off Request

Please fill in your details and you will receive an email confirmation if your request is approved or denied. Completing this form does not automatically ensure your request will be accepted. Please provide this no later then 2 weeks in advance for review. Use this form to request time off in advance. If you are calling in for a scheduled shift, use the Call-In Notification Form and call the childcare center.

Classroom / Department

First Date Requested Off

Last Date Requested Off

Are you requesting full shifts or partial shifts?

Scheduled Shifts Affected

For Partial Shifts: Requested Departure and/or Return Time

Expected Return-to-Work Date

Total Work Hours Requested Off

Reason for Time Off*

Additional Information

Supporting Documentation

Do you expect to submit supporting documentation?

Upload Supporting Documentation

Upload your file

Choose a file or drag and drop one here.

Which benefits are you requesting to use?

If you selected multiple benefits please indicate the amount of hours for each one

Total Benefit Hours Requested

Employee Acknowledgment

Please check each box before submitting:

I understand that this submission is a request and does not automatically approve my time off or requested benefits.

I understand that administration will review my request and notify me of its decision, subject to applicable leave protections.

I understand that I am responsible for submitting supporting documentation when lawfully required.

I understand that taking unapproved time off may result in an unexcused absence and corrective or disciplinary action, subject to applicable law. Legally protected absences will not be treated as disciplinary violations.

I understand that I am responsible for reviewing the employee handbook and attendance policy at www.mctlp.com.

I confirm that the information provided is accurate to the best of my knowledge.

Your Signature

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Employee Time-Off Request

Classroom / Department

First Date Requested Off

Last Date Requested Off

Are you requesting full shifts or partial shifts?

Scheduled Shifts Affected

For Partial Shifts: Requested Departure and/or Return Time

Expected Return-to-Work Date

Total Work Hours Requested Off

Reason for Time Off*

Additional Information

Supporting Documentation

Do you expect to submit supporting documentation?

Upload Supporting Documentation

Upload your file

Choose a file or drag and drop one here.

Which benefits are you requesting to use?

If you selected multiple benefits please indicate the amount of hours for each one

Total Benefit Hours Requested

Employee Acknowledgment

Please check each box before submitting:

I understand that this submission is a request and does not automatically approve my time off or requested benefits.

I understand that administration will review my request and notify me of its decision, subject to applicable leave protections.

I understand that I am responsible for submitting supporting documentation when lawfully required.

I understand that I am responsible for reviewing the employee handbook and attendance policy at www.mctlp.com.

I confirm that the information provided is accurate to the best of my knowledge.

Your Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Employee Time-Off Request

Requested Time Off

Reason for Request

Supporting Documentation

Upload your file

Benefits Requested

Employee Acknowledgment

Employee Time-Off Request

Requested Time Off

Reason for Request

Supporting Documentation

Upload your file

Benefits Requested

Employee Acknowledgment