Sick Leave Bank Request
If you would like to request days from the Sick Leave Bank, please fill out the form below. After the form is submitted, your request will be submitted the SLB committee. To learn more about the SLB please refer to CCSD #1 District Policy GCBD or GDBD. If you have any questions please feel free to contact Human Resources at (307) 283-2299 or by emailing Sherri Moeller at moellers@crook1.com.
Name
*
First Name
Last Name
What building do you work in?
*
Central Office (District-wide)
Hulett
Moorcroft Elementary
Moorcroft Secondary
Sundance Elementary
Sundance Secondary
What is your position at CCSD#1?
*
How many years have you worked at CCSD#1?
*
Have you used all of your sick leave?
Yes
No
Don't know
How many days would you like to request from the sick leave bank? (extra days cannot be requested for future use)
*
Is there any information you would like to share with the sick leave bank committee? (optional)
Submit
Should be Empty: