Volunteer (VTO) Leave Request Form

Volunteer (VTO) Leave Request Form

If you have not been an employee for at least 6 months of continuous employment, you are not eligible for Volunteer Leave at this time.
Full Legal Name*

First NameLast Name
CPR Email Address*
example@example.com
What was your hire date?*

MonthDayYear
Date
Are you FT or PT?*

Full-time benefit eligible (35+ hours)Part-time benefit eligible (30-34 hours)Part-time not benefit eligible (29 hours or less)
Have you already used VTO during the current calendar year (Jan-Dec)?*

YesNo
Please provide the name of the organization, contact person, location address and phone number for where you plan to volunteer.
Name of the Organization*
Contact Name*

First NameLast Name
Location Address*
Contact Number*
Please enter a valid phone number.
How many hours do you plan to volunteer?

1 day2 days
How many hours do you plan to volunteer?*
Date(s) you plan to volunteer:*
Date you plan to volunteer:

MonthDayYear
Date
Supervisor's Full Legal Name*

First NameLast Name
Supervisor's CPR Email Address*
example@example.com
Supervisor's Status*

ApprovedDenied
Reason for denial:*
Supervisor Signature*

Clear
Should be Empty: