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CCISD RETURN TO WORK REQUEST
Request must be approved by the Personnel Office prior to returning to work.
You and your supervisor must have written authorization before returning to work. Both parties will receive an email.  Updated per local guidance 1/3/22
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Employee Last Name *
Employee First Name *
Employee Phone contact *
Dates Absent *
Campus/Department *
Required
Requesting to return on what date: *
MM
/
DD
/
YYYY
Date Positive
MM
/
DD
/
YYYY
Employee Return *
Required
Employee Signature/Date: (Type name & date below) *
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