Staff Member Substitute Form
Section 10. Teacher Substitutions: Teachers who agree, at the request of the District, to substitute by assuming supervision for another teacher shall receive a sum of one-fifth (1/5) of current short term substitute pay per fifty (50) minutes for all such substitutions. Each substitution will be logged on forms provided by the District and submitted by the teacher to the respective principal who will submit same for the monthly disbursal of payments for these substitutions
Employee Name
First Name
Last Name
Employee Email
example@example.com
Supervisor
*
David Bunn
Nick Jurrens
Date of Substitution
-
Month
-
Day
Year
Date
Staff Member you subbed for
First Name
Last Name
Period(s) of Substitution
Period 1
Period 2
Period 3
Period 4
Period 5
Period 6
Period 7
Start Time of Substitution
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
End Time of Substitution
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Employee Signature
Clear
Submit Form
Print Form
Should be Empty: