Benefit Time Authorization Request Form

** For Canadian Employees Only **

This form will be submitted via email to your supervisor for approval.

*PTO must be approved in advance.

Name*

First Name

Last Name

Location*

Field Toronto Office

Platform/ Department*

Please fill in your Platform information (i.e. Toronto, Montreal, Calgary, Edmonton, Toronto Support Center...)

Your Supervisor's Email Address*

Your Email Address*

Start Date*

End Date*

Benefit Time Category*

SICK PTO Jury Duty Bereavement

Number of Days Requested*

Start: Date*

Start :Time*

Half Day (4 Hours) Full Day (8 Hours)

End :Date*

End: Time*

Half Day (4 Hours) Full Day (8 Hours)

Benefit Time Category*

PRO PTO Sick Jury Duty Bereavement

Number of Days Requested*

Must be whole values or half values