MSE 2022-23 Mendenhall Leave Request Form

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Please submit the times you need to take off work and the type of leave you are taking.

Email *

Leaves and Absences

- The school grants up to nine (9) local leave days annually to all school employees. The school also grants (one) 1 additional local leave day for administrators.

- An employee wishing to take anticipated local leave must submit this form (5) days in advance of the anticipated absence.

- Anticipated local leave may not be taken for more than three consecutive days, except in extenuating circumstances as determined by the Principal or Director.

- In deciding to approve anticipated local leave, however, the Principal shall consider the effect of the employee’s absence on the educational program, as well as the availability of substitutes.

Anticipated local leave is NOT allowed:

Anticipated local leave is NOT allowed in the following circumstances except in extenuating circumstances as determined by the Principal:

- The day before a school holiday.

- The day after a school holiday.

- Days scheduled for end-of-semester or end-of-year exams.

- Days scheduled for State Test tests.

- District norm-referenced testing days.

- Professional or staff development days.

- Parent Teacher Conferences

- Last week of each semester. (Executive Director or his/her designee approval required)

Name

Enter the total amount of days requested PTO

( e.g 1 Full Day, 2 days, Half Day, Quarter Day etc.)

Department:

Type of leave *

Sick leave (Illness or Injury)

Bereavement leave (Immediate family up to 3 days in a year with supporting document)

Vacation

Personal leave

Jury duty or legal leave (Documentation Required)

Emergency leave

Military Duty (Documentation Required)

Professional Development (Documentation Required)

Other:

Date of Leave

YYYY

Time *

Full day

Date of Return

YYYY

If partial day, how much leave is requested?

1/4 day ( 2 periods/hours)

1/2 day ( 4 periods/hours)

Clear selection

If partial day, please list departure and returning time(s).

Reason *

Do you need a substitute? *

Yes

Please leave details regarding where sub work can be found. *

Note: Each teacher is required to have a substitute folder readily accessible containing the following:  Lesson plans  Seating charts  Class rosters  Discipline plan  Fire drill and disaster routes  Duties/Special instructions unique to your location or subject area.

Sub Folder Requirements

A copy of your responses will be emailed to the address you provided.

Submit

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