Faculty/Staff Leave Request Form

Faculty/Staff Leave Request      revised: 8-2002

Name:_________________________________ Approved:____________ by Beth Hill:_________________

Date/s Requested :_____________________________________ request submitted:__________________

Reason  (circle one):   

        Health  --  Personal --  Professional -- Jury Duty --  Paternity/Adoptive --  Other

Comments: _______________________________________________________________________  

       ______________________________________________________________________________

Mods that need coverage and number of students in each:

                   ______________________________________________________________________________

                   ______________________________________________________________________________

Lesson Plans / Class Lists and all Copies needed for each class

are to be organized by Mods (individual packets) and given to the front office before leaving. 

Students may have to be moved for coverages, please make all assignments mobile. 

Do Not Plan on Showing a Film without Principal’s permission.

STRONGLY SUGGEST THAT TESTS / QUIZZES NOT BE GIVEN IN YOUR ABSENCES.