Time off request
Please submit the times you need to take off work and the type of leave you are taking.
Type of leave
Description if needed. Fusce dapibus, tellus ac cursus commodo, tortor mauris condimentum.
Sick (Illness or Injury)
Bereavement (Immediate Family)
Jury duty or legal leave
Reason for leave
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Peoria Regional Office of Education.