Faculty/Staff Absence Request Form
Please submit this form as soon as possible for all scheduled and unscheduled absences. The employee is responsible for verifying that scheduled absences do not conflict with scheduled staff meetings.
Name
*
First Name
Last Name
Email
*
example@statesvillechristian.org
Direct Reports Email:
*
sjordan@statesvillechristian.org lcorson@statesvillechristian.org smartin@statesvillechristian.org
Duration of Absence
*
Half Day
Full Day
Multiple Days
Which portion of the day?
*
Half Day AM
Half Day PM
Other
Date of Absence:
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Absence
*
Professional
Personal
Illness
Vacation (Office/Admin Staff only)
Bereavement
School Sponsored Event
Start Date:
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
End Date:
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
If illness, please explain:
*
If professional, please explain:
*
If School Sponsored Event, please explain:
*
Time missed (if less than 1/2 day):
Substitute Name(s) (for all 1/2 and full day absences):
*
NA if no sub is needed
Additional Notes:
By signing this I have verified that the dates I am requesting off do not conflict with a scheduled staff meeting. If the date(s) requested do conflict with a scheduled staff meeting please reach out to your direct report.
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Continue
Continue
Should be Empty: