Riviera ISD - ABSENCE FROM DUTY REPORT
EMPLOYEE *
Select Your Name From The List
CAMPUS/DEPARTMENT *
Select Your Campus/Department From the List
POSITION HELD BY EMPLOYEE *
Type In Your Position
Your answer
BEGINNING DATE OF ABSENCE *
Select Date From Calendar
MM
/
DD
/
YYYY
ENDING DATE OF ABSENCE *
Select Date From Calendar
MM
/
DD
/
YYYY
NUMBER OF DAYS ABSENT *
Use ".5" for Half Days
Your answer
For Half Days
Is it the Morning half or the Afternoon?
LEAVE TO BE USED
ABSENCE DEDUCTED FROM
If Absence from Duty was due to a death, please indicate relationship of deceased
Your answer
NOTE:
Each employee must submit an Absence from Duty report immediately after returning to duty. A written statement from the attending physician or practitioner must be submitted for an absence of more than three (3) consecutive days. This physician's statement should be attached to this form. All leave requests will be granted in accordance with Board Policy DEC (Local). If employee attended a workshop, a copy of the certificate must be attached to this form. If the absence was for jury duty, a copy of the summons must be attached to this form.
Your answer
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