WCED

Leave Request Form

Please be sure to complete all fields before submitting for approval.

Name:         

Position:Certified Staff  Non-Certified Staff  Administration   

You must indicate the type of leave you are requesting.

Type of Leave Requested: 
VacationSickPersonalBereavementDiscretionaryUnpaid

Date of Request:  JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember      Day: 12345678910111213141516171819202122232425262728293031      Year: 2023

Start Date:           JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember      Day: 12345678910111213141516171819202122232425262728293031      Year: 2023

End Date:            JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember      Day: 12345678910111213141516171819202122232425262728293031      Year: 2023

Start Time:            6:00 am6:30 am7:00 am7:30 am8:00 am8:30 am9:00 am9:30 am10:00 am10:30 am11:00 am11:30 am12:00 pm12:30 pm1:00 pm1:30 pm2:00 pm2:30 pm3:00 pm3:30 pm4:00 pm4:30 pm5:00 pm5:30 pm6:00 pm      End Time:   6:00 am6:30 am7:00 am7:30 am8:00 am8:30 am9:00 am9:30 am10:00 am10:30 am11:00 am11:30 am12:00 pm12:30 pm1:00 pm1:30 pm2:00 pm2:30 pm3:00 pm3:30 pm4:00 pm4:30 pm5:00 pm5:30 pm6:00 pm

Calculate and enter the number of hours you will be gone (by half hour increments).

Please give a brief reason for your leave request:

After submitting, your request will be forwarded to your direct supervisor for approval.  

If you do not hear from the supervisor regarding the request for leave within 48 hours, you

should follow up by e-mail.