Request for Leave--High School

Request for Leave--High School

	Leave Request Form Professional / Paraprofessional / Health Service / Civil Service Staff

	This is a (please check one): *
	This is a (please check one): * Personal Day Request Bereavement Day Request Vacation Day Request Unpaid Day Request

	Name of Employee:*

	Date Form Submitted:*
	mm/dd/yyyy

	Position:*

	Building:*

	Date of Absence(s)*

	I will be absent (please check one): *
	I will be absent (please check one): * A.M. only P.M. only All Day

	Please note: Personal leave for all applicable staff is only authorized for business that cannot be conducted outside school hours.

	Bereavement Leave:

	Reason: To be used only for any additional leave beyond the three (3) days granted by the district. Please include the family member relationship.

	FOR CIVIL SERVICE STAFF ONLY

	Reason: IN ORDER FOR A PERSONAL BUSINESS DAY TO BE APPROVED, IT MUST BE DEMONSTRATED THAT THERE IS A NEED TO TRANSACT BUSINESS THAT CANNOT BE CONDUCTED AFTER SCHOOL HOURS OR THAT THERE EXISTS OTHER SUFFICIENT COMPELLING REASON.

	School email address:*

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