D62 Iroquois Community School Request for Leave Form
Email address *
Employee Full Name *
Your answer
Please select an option below: *
Position in the district? *
Your answer
Start Date and Time of Absence *
Full day example: 8am-4pm. Partial day example: 8am-12pm or 12pm-4pm.
MM
/
DD
/
YYYY
Time
:
End Date and Time of Absence *
Full day example: 8am-4pm. Partial day example: 8am-12pm or 12pm-4pm.
MM
/
DD
/
YYYY
Time
:
Is your date of absence in conjunction with a holiday or school recess? *
*If you choose Yes, please provide a short explanation in the next question.
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