Series 403.3.1.4.1P - Transportation Employee Request for Absence of Two Days or Less

 

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