Time Off Request Form Template

<form action="https://splitforms.com/api/submit" method="POST">
  <input type="hidden" name="access_key" value="YOUR_ACCESS_KEY">
  <input type="hidden" name="subject" value="New time off request">
  <input type="hidden" name="form_loaded_at" id="form_loaded_at">

  <fieldset>
    <legend>Employee</legend>
    <label>Full name <input type="text" name="employee_name" autocomplete="name" required></label>
    <label>Work email <input type="email" name="email" autocomplete="email" required></label>
    <label>Team or department <input type="text" name="department" required></label>
    <label>Manager's name <input type="text" name="manager_name" required></label>
  </fieldset>

  <fieldset>
    <legend>Type of leave</legend>
    <label><input type="radio" name="leave_type" value="Vacation" required> Vacation / PTO</label>
    <label><input type="radio" name="leave_type" value="Sick"> Sick</label>
    <label><input type="radio" name="leave_type" value="Personal"> Personal</label>
    <label><input type="radio" name="leave_type" value="Unpaid"> Unpaid</label>
    <label><input type="radio" name="leave_type" value="Other"> Other (say which in the notes)</label>
  </fieldset>

  <fieldset>
    <legend>Dates</legend>
    <label>First day off <input type="date" name="start_date" id="start_date" required></label>
    <label>Last day off <input type="date" name="end_date" id="end_date" required></label>
    <label>Total hours requested
      <input type="number" name="hours_requested" min="0.5" step="0.5" required>
    </label>
  </fieldset>

  <label>Who will cover your work or shifts?
    <textarea name="coverage" rows="3" placeholder="Name of the person covering, or the shifts that need covering"></textarea>
  </label>

  <label>Notes for your manager (optional). Please do not include medical details.
    <textarea name="notes" rows="3"></textarea>
  </label>

  <!-- honeypot: leave empty -->
  <input type="checkbox" name="botcheck" style="display:none" tabindex="-1" autocomplete="off">

  <button type="submit">Send time off request</button>
</form>
<script>
  document.getElementById('form_loaded_at').value = Date.now();
  // Stop the last day being set before the first day.
  var start = document.getElementById('start_date');
  var end = document.getElementById('end_date');
  start.addEventListener('change', function () {
    end.min = start.value;
    if (end.value && end.value < start.value) end.value = start.value;
  });
</script>