Child Court Leave Request Form
Please complete this form to request leave related to a child court matter. All fields are required unless otherwise noted.
Your Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Child's Full Name
*
First Name
Last Name
Relationship to Child
*
Please Select
Parent
Legal Guardian
Foster Parent
Other
Court Case Reference (if applicable)
Requested Leave Dates
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Leave Request
*
Upload Supporting Documents (optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Submit Leave Request
Should be Empty: