Leave Request Form
* Required
Email address
*
Your email
Employee Name:
*
Your answer
Today's Date:
*
MM
/
DD
/
YYYY
Type of Leave:
*
Choose
Administrative
Coaching
Department Chair
Emergency
Funeral
IEP
ISS
Personal
Professional
Sick
Special
Vacation
Quarantined - work from home
Quarantined - sub needed
Date(s) of Leave:
*
Your answer
Length of Leave
*
Choose
1/2 Day
Full Day
Time of Day
*
Choose
AM
PM
All Day
Reason for Request:
Your answer
Courses to be covered:
*
1
2
3
4
5
6
7
8
Lunch & Learn A
Lunch & Learn B
No Sub Required
Required
Signature of Employee:
*
By entering my name, I agree that this is equivalent to my handwritten signature.
Your answer
ADMINISTRATION AUTHORIZATION SECTION
Supervisor or Principal Authorization
Approved
Denied
Comments:
Your answer
Supervisor/Principal Signature:
Your answer
Superintendent Authorization
Approved
Denied
Comments:
Your answer
Superintendent Signature:
Your answer
A copy of your responses will be emailed to the address you provided.
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