Leave Request - United Way of the River Cities

Time Off Request Form

Name *

First day of leave *

Last day of leave *

Number of PTO hours used *

Number of Floating Holidays used *

Note

Employee Signature *

Date Submitted *

If you are human, leave this field blank.

820 Madison Ave.,

Huntington, WV 25704

Phone: 304-523-8929

Hours of Operation

Monday-Friday: 8 a.m.-4:30 p.m.

Saturday-Sunday: Closed

You can quickly hide this sidebar by removing widgets from the Hidden Sidebar Settings.