Series 403.3.1.4.1P - Transportation Employee Request for Absence of Two Days or Less
Adopted: May 1980
Revised: March 2004
I,________________________________________, #________________ request permission to be
(print name) (employee number)
absent from my regular duties: AM_____ NOON_____ PM_____ Activity_____ Other_____
Date(s) of requested absence ___________________________ Circle ( M T W TH F )
date(s)
Reason for absence ___________________________________________________________
_____________________________________________________________________________
Check:
_____ Driver (Bus #'s)__________________________________________________________
_____ Chaperone (Bus #'s)______________________________________________________
_____ Crossing Guard (Location)________________________________________________
Time and date of request ____________AM/PM __________________
Employee signature ______________________________________
Logged___________ Approved___________ Disapproved___________
By_______________________________________
(Coordinator of Transportation or Designee)
Procedures/403.3.1.4.1P/3-15-04