Please fill out the form below:
Employee Name (required)
Employee Email (required)
Supervisor Name (required)
Supervisor Email (required)
I request paid sick time ("PST") on the following date(s). For each date specify the numbers of PST hours requested.
Are you requesting time off for a qualifying healthcare or legal reason, as outlined in our PST Policy, for all of the above-requested PST hours?
If no, please specify: