Drew Central High School
Leave Request Form
This form must be completed and returned to the office as soon as the employee is aware that a leave of absence is required.
| Name:______________________________ | Today's Date__________________ |
Date(s) of leave:_______________________________
Type of leave requested:
| ____ Sick Leave | ____ Personal Leave |
| ____ Professional Leave | ____ Jury Duty |
| ____ Funeral Leave | ____ Other(describe) |
| ____________________________________ | ____________________________________ |
|
Employee Signature |
Principal Signature |
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Office Use Only
Recorded:______________
Substitute Hired:_____________