EMPLOYEE NAME:
*
EMPLOYEE ID
EMPLOYEE EMAIL
*
example@example.com
REPORTING ABSENT ON
-
Year
-
Month
Day
Date
TYPE OF LEAVE
*
Illness of Self
Illness/Death of Relative
Personal
Injury at Work (Explain)
Contagious Disease (Contracted at Work)
Vacation
Temporary Duty (Explain)
LWOP, Auth (Explain)
LWOP, Unauth (Explain)
Compensatory Time
Jury Duty/Subpoenaed
Opt Day
Elected Official
Military Training
Union Representative
Union Official Business
Union Pool Day
Other
LEAVE AMOUNT
Full Day
AM Half Day (note sub coverage cannot be provided and you will need to provide coverage)
PM Half Day (note sub coverage cannot be provided and you will need to provide coverage)
COMMENTS:
LINE 1
LESSON PLAN
EMPLOYEE SIGNATURE
*
NOTIFICATION EMAIL
example@example.com
Submit
Should be Empty: