*Absence of Duty (make a copy to use)

	A	B	C	E	F	G	H	I	J	K
1
2	JOHN SWETT UNIFIED SCHOOL DISTRICT
3	400 Parker Ave., Rodeo, CA 94572
4				Absence from Duty
5
6	Employee Name:					Employee #
7
8
9	School Site:		DO	RHE		CMS		JSH		Willow
10
11
12	Type of Absence			Dates of Absence			Classified		Certificated
13
14		Sick Leave (personal Illness)					Hrs:		Day/Per
15
16		Personal Necessity (with pay)					Hrs:		Day/Per
17		Reason
18
19		Personal Business (with pay)					Hrs:		Day/Per
20
21		Vacation (11/12 employees only)					Hrs:		Day/Per
22
23		School Business (full pay)					Hrs:		Day/Per
24		Activity
25
26		Jury Duty (full pay)					Hrs:		Day/Per
27		Proof of Jury Duty must be given to district
28
29		Bereavement (full pay)					Hrs:		Day/Per
30		Relationship:
31
32		Absence without pay					Hrs:		Day/Per
33
34		Other without pay					Hrs:		Day/Per
35
36		Comp Time					Hrs:		Day/Per
37
38
39
40
41	Employee Signature				Principal/Supervisor Signature
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100