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ES Staff Absentee Request
Complete to request time off.
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* Indicates required question
This request MUST BE completed for each day you are absent, which includes consecutive days. Example: if you are absent 2 days in a row, complete 2 requests.
Date Requested
MM
/
DD
/
YYYY
First Name
*
Your answer
Last Name
*
Your answer
Date of Absence:
MM
/
DD
/
YYYY
Dates of Absent:
Please list if absence is consecutive days.
Your answer
Time of Absence:
Please list time leaving, or full day or half day.
Your answer
Bereavement
Clear selection
Bereavement
Please list family relationship.
Your answer
Reason:
Mark only 1 choice
Professional
Personal
Illness
Clear selection
Professional Explanation
List Group Ex. UIL, SPED, TITLE I, GT, ATHLETICS, CAMPUS
Your answer
Substitute Needed:
*
Yes
No
Requester Email:
*
Your answer
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