Medical/Maternity Leave form
Please complete this form as soon as you know your leave dates.  Induction Leadership will contact you to finalize.
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First and Last Name (as it appears in InductionSupport.com) *
District *
School *
Current Date *
MM
/
DD
/
YYYY
Best E-Mail Address *
Best Phone Number *
Preferred method of contact *
Induction Year *
I will need to take leave from my SCOE Induction experience for the following reason: *
I have a scheduled leave date of:
MM
/
DD
/
YYYY
I have a scheduled return to work date of:
MM
/
DD
/
YYYY
I will be missing two or less event dates: *
I have informed my district of this Induction Leave. *
I have informed my Mentor of this Induction Leave. *
I would like to put the following plan into effect to complete this year of Induction (Induction Leadership will contact you to finalize). *
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