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Vacation Request
This template for a vacation request form provides all the typical fields that you might include. From manager approval to balancing vacation spent and accrued you can use this template as a starting point for your company's process for handling vacation requests.

Free Sample Template
Format: Word PDF
# of Pages: 1
Printable: Yes


Vacation Request TemplateForm 4219
Format: Word PDF
Category: Employee, Schedule
Type: Request

Vacation Request

Date: ___/___/_____

Employee Name: _______________________________________________________________________________

Department: ___________________________________________________________________________________

Supervisor’s Name: _____________________________________________________________________________

Hire Date: ___/___/_____

Vacation Earned:

[___] Employed One Year…Results in one week (five work days) of paid vacation.

[___] Employed Two Years…Results in two weeks (ten work days) of paid vacation.

[___] Employed Three or more years…Results in three weeks (fifteen work days) of paid vacation.

Dates of Vacation: ___/___/_____ to ___/___/_____

Previous number of days taken: _________________

Number of days for this request: ________________

Balance of vacation remaining: __________________

Employee’s Signature: _________________________________________________________ Date: ___/___/_____

Supervisor’s Signature: ________________________________________________________ Date: ___/___/_____

Manager’s Approval:

[___] Approved

[___] Rejected

Notes: ________________________________________________________________________________________

_____________________________________________________________________________________________

Manager’s Signature: __________________________________________________________ Date: ___/___/_____