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Teacher & Staff Leave of Absence
This form must be completed for ANY personal time taken.
All vacations and leaves must be submitted
two weeks in advance
with final approval from Administration.
Initiated by:
*
Teacher/staff name:
*
Position:
*
Upper school teacher
Lower school teacher
Elective teacher
Other
E-mail address:
*
Day(s) and date(s) to be absent:
*
Total hours to be absent:
*
Work hours to be absent (for example: 8:30 a.m. to 2:30 p.m.)
*
Reason for leave:
*
Bereavement
Jury duty
Other
Is a substitute needed?
*
yes
no
Name of substitute: (please contact sub before completing this form)
*
Time(s) and hours sub is needed:
*
Is an additional sub needed?
*
yes
no
Additional Sub:
Time(s) and hours sub is needed:
*
Is an additional sub needed?
*
yes
no
Additional Sub:
Time(s) and hours sub is needed:
*
Is an additional sub needed?
*
yes
no
Additional Sub:
Time(s) and hours sub is needed:
*
Employee signature:
*
clear
Date:
*
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