Employee Absence Form

EMPLOYEE ABSENCE

LAST Name *

FIRST Name *

Position *

Throop Assistant or Office Staff Throop Cafeteria Throop Custodian Throop Teacher, Admin, Other Certified Jr-Sr High Assistant or Office Staff Jr-Sr High Cafeteria Jr-Sr High Custodian Jr-Sr High Teacher, Admin, Other Certified Custodial or Maintenance Supt Office, Tech SCASEC SHARED

Date(s) of Absence(s) *

Date of Absence(s) *

Specify any of the above dates if Half AM or Half PM

Leave this blank if absences are full days

Type of Absence *

Specify Relation *

(For Family Illness or Bereavement)

Name of PD, Meeting or Field Trip (must be pre-approved) *

Signature *

Clear

DISTRIBUTION (Corp Use Only)

Sub $ Amount

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