SOUTH RIVER PUBLIC SCHOOLS
VACATION CARRYOVER REQUEST FORM
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(Today’s Date)
NAME _________________________________ ASSIGNMENT __________________
SCHOOL: _______________________________
Reason for the vacation carryover: ___________________________________________
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Number of Vacation Days Taken This Year to Date: __________
Number of Vacation Days Remaining to Date: ___________
Number of Vacation Days Requesting to Carryover: __________
(you are not able to carry over accumulated vacation days)
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Employee’s Signature (Date)
_____________________________________ _________________________________
Director’s Signature (Date) Principal’s Signature (Date)
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SUPERINTENDENT’S OFFICE ONLY
Carryover Approved: ____ Yes ____ No
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Superintendent’s Signature (Date)
EMAIL COMPLETED FORM TO DAWN ZUKOWSKI AND COPY ROBIN STEINHAUSEN. DO NOT SEND INTEROFFICE. YOU WILL BE NOTIFIED VIA EMAIL ONCE YOUR REQUEST HAS BEEN REVIEWED.
3/2024