Request to Leave Early or Arrive Late

SOUTH DADE SENIOR HIGH SCHOOL
LEAVE EARLY OR ARRIVE LATE FORM
*Form must be submitted 72 hours prior to date of request. *Request must be presented to the administrator supervising your department.

*Employee is responsible for securing class coverage when applicable.

*Time over the two-hour rule will be charged half day.

*Midday and Leaving Early you must sign out in the sign out book located in 1107.
Date

MonthDayYear
Date
Employee Name
Department
TYPE OF LEAVE: I AM REQUESTING TO
I am requesting to

Leave EarlyLeave MiddayArrive late
FOR WHAT DATE IS REQUEST

MonthDayYear
Date
Brief Explanation
LEAVING EARLY DETAILS
TIME LEAVING
LEAVE AND RETURN DETAILS
LEAVE TIME
RETURN TIME
ARRIVE LATE DETAILS
TIME ARRIVING
Employees Signature

Clear
Date

MonthDayYear
Date
Should be Empty: