Substitute Compensation
Request Form
Is substitute a current employee at the school?
*
Yes
No
Substitute Information
Name
*
First Name
Last Name
E-mail Address
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Substitute will be compensated by:
*
Hours per Day
Hours Per Week
Description
{substituteWill} Substituted
*
/
Month
/
Day
Year
Date
Will the substitute be compensated for their time through payment or by receiving additional PTO days?
*
Payment
PTO days
Number of Hours
*
include decimals for partial hours
Pay Options
Please Select
Standard pay rate
Specialized Pay Rate
Specialized Pay Rate
*
Compensation
$
For class
*
Please Select
Preschool
K-8
Teacher Subbing For
Would you like to add another instance?
*
Yes
No
{substituteWill} Substituted
*
/
Month
/
Day
Year
Date
Will the substitute be compensated for their time through payment or by receiving additional PTO days?
*
Payment
PTO days
Number of Hours
*
include decimals for partial hours
Pay Options
Please Select
Standard pay rate
Specialized Pay Rate
Specialized Pay Rate
*
Compensation
$
For class
*
Please Select
Preschool
K-8
Teacher Subbing For
Would you like to add another instance?
*
Yes
No
{substituteWill} Substituted
*
/
Month
/
Day
Year
Date
Will the substitute be compensated for their time through payment or by receiving additional PTO days?
*
Payment
PTO days
Number of Hours
*
include decimals for partial hours
Pay Options
Please Select
Standard pay rate
Specialized Pay Rate
Specialized Pay Rate
*
Compensation
$
For class
*
Please Select
Preschool
K-8
Teacher Subbing For
Would you like to add another instance?
*
Yes
No
{substituteWill} Substituted
*
/
Month
/
Day
Year
Date
Will the substitute be compensated for their time through payment or by receiving additional PTO days?
*
Payment
PTO days
Number of Hours
*
include decimals for partial hours
Pay Options
Please Select
Standard pay rate
Specialized Pay Rate
Specialized Pay Rate
*
Compensation
$
For class
*
Please Select
Preschool
K-8
Teacher Subbing For
Would you like to add another instance?
*
Yes
No
{substituteWill} Substituted
*
/
Month
/
Day
Year
Date
Will the substitute be compensated for their time through payment or by receiving additional PTO days?
*
Payment
PTO days
Number of Hours
*
include decimals for partial hours
Pay Options
Please Select
Standard pay rate
Specialized Pay Rate
Specialized Pay Rate
*
Compensation
$
For class
*
Please Select
Preschool
K-8
Teacher Subbing For
Would you like to add another instance?
*
Yes
No
{substituteWill} Substituted
*
/
Month
/
Day
Year
Date
Will the substitute be compensated for their time through payment or by receiving additional PTO days?
*
Payment
PTO days
Number of Hours
*
include decimals for partial hours
Pay Options
Please Select
Standard pay rate
Specialized Pay Rate
Specialized Pay Rate
*
Compensation
$
For class
*
Please Select
Preschool
K-8
Teacher Subbing For
Total Compensation
$
Submitted by
Please be advised that this form should be submitted with Supervisor approval
Supervisor
*
Please Select
Rabbi Goldberg
Mrs. Gita Hirsch
Mrs. Malca Schwarzmer
Mrs. Shifra Mandel
Rabbi Pollack
Rabbi Jacknis
Rabbi Youkhehpaz
Email Address
*
example@example.com
Full Name
*
First Name
Last Name
Approval Status
*
Please Select
Approved
Denied
Supervisor Signature
*
Today's Date
*
/
Month
/
Day
Year
Date
Submit
Should be Empty: