Time-off Request Form

This is TriCorps Security’s Time-off Request Form. All requests are subject to manager approval. Please fill this out accurately and completely.

"*" indicates required fields

Employee Name*

First Last

Email*

Employee Number

Supervisor / Manager Name*

Supervisor Email*

Today's Date*

Reason For Request*

If other, please explain:*

Time-off Start Date

This will be the first day that you’ll need off work.

Time-off End Date

This will be the last day you’ll need off work.

Date*

This field is for validation purposes and should be left unchanged.

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