LEAVE OF ABSENCE REQUEST FORM  -  Madison Metropolitan School District
Please fill out completely in advance of the leave where possible.  The Employee Handbook references any applicable deadlines.  Contact the Benefits Division if you have questions about completing this form.
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Email *
EMPLOYEE INFORMATION
ALL ITEMS REQUIRED
Full Name *
Employee Number *
*
Supervisor Name *
POSITION and FTE *
REGULAR WORK SCHEDULE (List days of the week and hours per day worked): *
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