Leave Request Form

Wendell School District #232

Leave Request Form
Name*

First NameLast Name
Todays Date*

MonthDayYear
Date Leaving*

MonthDayYear
Days Gone*
Supervisor*
Leave Type*
Requirements for each Leave Type can be found in the Staff Handbook. In the provided comments box below, please provide short details for Activity Leave and/or Bereavement Leave. If this is a Professional Leave, please fill out the Professional Leave form after completing your leave request.
Comments:*
Employee Signature*
By checking this box I agree my electronic signature is the legal equivalent of my manual signature on this Agreement*

Agree
The following is for administrative use only.
Supervisor Signature
Supervisor Code
Approved
Supervisor/Superintendent must fill in their code and select yes or no in the "Approved" field.
Superintendent Signature
Superintendent Code
Approved
FormName
Should be Empty:

Wendell School District #232