2023-2024 Leave of Absence (LOA) Request

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If you are planning to take a Personal or Medical LOA for the 2023-24 MSA period, please complete the form below.

This form is also to be completed if the need arises to take an unplanned LOA at any point during the 2023-24 MSA period.

For a detailed explanation of the LOA policy and requirements, please review Section 10 of Board Policy.

Email *

First name *

Last Name *

Please provide your telephone number *

Please select the type of LOA you are requesting *

COVID (available at any time, no impact to status)

Medical (requires doctor's note)

College (must meet criteria listed in Section 10 of Board Policies)

Personal (non-medical)

Please provide an explanation for your Leave of Absence request for the 2023-24 MSA period: *

Submit

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