Staff Leave Request Form
Submit your leave details for the 2026–2027 school year; approval is not guaranteed until administration reviews your request.
Employee Name
*
First Name
Last Name
Work Email Address
*
example@example.com
Position
*
Full Time or Part Time
*
Full Time
Part Time
Campus
*
Please Select
Little Lambs
Market St
Roc Center
Immediate Supervisor
*
Type of Leave Requested
*
Personal Leave
Sick Leave
Vacation Leave
Professional Development
Bereavement Leave
Family/Personal Emergency
Jury Duty
Unpaid Leave
Call Out
Other
Requested Leave Start Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Requested Leave End Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Is this leave for a full day or partial day?
*
Full Day
Partial Day
Number of Days or Hours Requested
*
Leave Reason/Details
*
Provide any information administration needs to process your request. Please do not include unnecessary medical or confidential information.
Will a Purpose Partner or coverage be needed?
*
Yes
No
Additional Notes
Upload Supporting Documentation (if applicable)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Please note: Submitting this request does not guarantee approval. You will receive an email notification once your request has been reviewed.
Submit Leave Request
Should be Empty: