Elementary Leave Of Absence Request
Fill this out to request a leave of absence
Name
Your answer
Type of Leave Requested:
Reason for requested leave:
Your answer
From: first day of leave
MM
/
DD
/
YYYY
To: last day of leave
MM
/
DD
/
YYYY
Portion of the Day
If you plan to be gone only part of the day:
Leaving at:
Time
:
Returning at:
Time
:
Do you need a substitute?
Comments and clarifications:
Your answer
Submit
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This form was created inside of Mount Ayr Community School.