Leave Request Form

Wendell School District #232

Leave Request Form
Name *

First Name Last Name
Todays Date *

Month Day Year
Date Leaving *

Month Day Year
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