Vacation Request Template

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2016
Vacation Request Template
Vacation time earned must be taken by June 30, 2017. Any vacation time not taken within the designated period will
be forfeited.
Please contact your direct supervisor for your vacation accrual amount for this calendar year. To assist you in scheduling
your vacation time, please indicate your choice of time by circling the applicable days on the calendar below. This
template can be used to request time from your direct supervisor.
July 2016
August 2016
September 2016
October 2016
S
M
T
W
T
F
S
S
M
T
W
T
F
S
S
M
T
W
T
F
S
S
M
T
W
T
F
S
1
2
1
2
3
4
5
6
1
2
3
1
3
4
5
6
7
8
9
7
8
9
10 11 12 13
4
5
6
7
8
9
10
2
3
4
5
6
7
8
10 11 12 13 14 15 16
14 15 16 17 18 19 20
11 12 13 14 15 16 17
9
10 11 12 13 14 15
17 18 19 20 21 22 23
21 22 23 24 25 26 27
18 19 20 21 22 23 24
16 17 18 19 20 21 22
24 25 26 27 28 29 30
28 29 30 31
25 26 27 28 29 30
23 24 25 26 27 28 29
31
30 31
November 2016
December 2016
January 2017
February 2017
S
M
T
W
T
F
S
S
M
T
W
T
F
S
S
M
T
W
T
F
S
S
M
T
W
T
F
S
1
2
3
4
5
1
2
3
1
2
3
4
5
6
7
1
2
3
4
6
7
8
9
10 11 12
4
5
6
7
8
9
10
8
9
10 11 12 13 14
5
6
7
8
9
10 11
13 14 15 16 17 18 19
11 12 13 14 15 16 17
15 16 17 18 19 20 21
12 13 14 15 16 17 18
20 21 22 23 24 25 26
18 19 20 21 22 23 24
22 23 24 25 26 27 28
19 20 21 22 23 24 25
27 28 29 30
25 26 27 28 29 30 31
29 30 31
26 27 28
March 2017
April 2017
May 2017
June 2017
S
M
T
W
T
F
S
S
M
T
W
T
F
S
S
M
T
W
T
F
S
S
M
T
W
T
F
S
1
2
3
4
1
1
2
3
4
5
6
1
2
3
5
6
7
8
9
10 11
2
3
4
5
6
7
8
7
8
9
10 11 12 13
4
5
6
7
8
9
10
12 13 14 15 16 17 18
9
10 11 12 13 14 15
14 15 16 17 18 19 20
11 12 13 14 15 16 17
19 20 21 22 23 24 25
16 17 18 19 20 21 22
21 22 23 24 25 26 27
18 19 20 21 22 23 24
26 27 28 29 30 31
23 24 25 26 27 28 29
28 29 30 31
25 26 27 28 29 30
30
Employee's Signature

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