Common use of Personal Discretionary Leave Clause in Contracts

Personal Discretionary Leave. Single Day Leave (May use 4 days of the 9 Personal Necessity Days as Personal Discretionary; if 4 days are used you will have 5 days of Personal Necessity remaining for the school year.) Reason does not need to be stated for Personal Discretionary Leave. Personal Discretionary Leave – Consecutive or used in conjunction with a Holiday / School Break. (No more than 2 days of the 4 days of Personal Discretionary Leave can be used consecutively or in conjunction with a holiday / school break. If 2 days are used consecutively, you can not take another day in conjunction with a holiday. Personal Discretionary will be deducted from Sick & Personal Necessity Leave) Verification of substitute required for 2 days leave Substitute needed? 🞏 Yes 🞏 No Substitute verified: 🞏 Yes 🞏 No ______ Staff Development / Conference Funding Source: ________________________________________________ ______ Other - Explain: _________________________________________________________ Total number of days absent: 1st Date Absent: Month Day Year Last Date Absent: Month Day Year Employee signature Date: APPROVED: ________________________________________ Date: ___________________ Supervisor APPROVED: ________________________________________ Date: ___________________ Superintendent White - Business Office Yellow - School Site Pink - To be returned to employee after approval Golden Rod – Employee 12/09 Appendix 5 XXXX UNION SCHOOL DISTRICT REQUEST FOR MATERNITY LEAVE SICK PAY OR EXTENDED DISABILITY COMPENSATION FROM: DATE: (Print Name) SCHOOL: I request that I be paid sick leave pay and/or extended disability pay for the following reasons stated by my physician. I realize that I may claim sick leave pay and/or disability pay for no more than that limited period of time when I am physically disabled from performing my duties because of pregnancy, miscarriage or recovery. This leave is not intended to provide for periods of rest prior to or following childbirth, or for childcare. Employee Signature

Personal Discretionary Leave. Single Day Leave (May use 4 days of the 9 Personal Necessity Days as Personal Discretionary; if 4 days are used you will have 5 days of Personal Necessity remaining for the school year.) Reason does not need to be stated for Personal Discretionary Leave. Personal Discretionary Leave – Consecutive or used in conjunction with a Holiday / School Break. (No more than 2 days of the 4 days of Personal Discretionary Leave can be used consecutively or in conjunction with a holiday / school break. If 2 days are used consecutively, you can not take another day in conjunction with a holiday. Personal Discretionary will be deducted from Sick & Personal Necessity Leave) Verification of substitute required for 2 days leave Substitute needed? 🞏o Yes �o � No Substitute verified: o 🞏 Yeso 🞏 No ______ Staff Development / Conference Funding Source: ________________________________________________ ______ Other - Explain: _________________________________________________________ Total number of days absent: 1st Date Absent: Month Day Year Last Date Absent: Month Day Year Employee signature Date: APPROVED: ________________________________________ Date: ___________________ Supervisor APPROVED: ________________________________________ Date: ___________________ Superintendent White - Business Office Yellow - School Site Pink - To be returned to employee after approval Golden Rod – Employee 12/09 Appendi00/00 x 5 XXXX UNXXXXX ION SCHOOL DISTRICT REQUEST FOR MATERNITY LEAVE SICK PAY OR EXTENDED DISABILITY COMPENSATION FROM: DATE: (Print Name) SCHOOL: I request that I be paid sick leave pay and/or extended disability pay for the following reasons stated by my physician. I realize that I may claim sick leave pay and/or disability pay for no more than that limited period of time when I am physically disabled from performing my duties because of pregnancy, miscarriage or recovery. This leave is not intended to provide for periods of rest prior to or following childbirth, or for childcare. Employee Signature

Personal Discretionary Leave. Single Day Leave (May use 4 days of the 9 Personal Necessity Days as Personal Discretionary; if 4 days are used you will have 5 days of Personal Necessity remaining for the school year.) Reason does not need to be stated for Personal Discretionary Leave. Personal Discretionary Leave – Consecutive or used in conjunction with a Holiday / School Break. (No more than 2 days of the 4 days of Personal Discretionary Leave can be used consecutively or in conjunction with a holiday / school break. If 2 days are used consecutively, you can not take another day in conjunction with a holiday. Personal Discretionary will be deducted from Sick & Personal Necessity Leave) Verification of substitute required for 2 days leave Substitute needed? 🞏o Yes �o � No Substitute verified: o 🞏 Yeso 🞏 No ______ Staff Development / Conference Funding Source: ________________________________________________ ______ Other - Explain: _________________________________________________________ Total number of days absent: 1st Date Absent: Month Day Year Last Date Absent: Month Day Year Employee signature Date: APPROVED: ________________________________________ Date: ___________________ Supervisor APPROVED: ________________________________________ Date: ___________________ Superintendent White - Business Office Yellow - School Site Pink - To be returned to employee after approval Golden Rod – Employee 12/09 Appendix 5 XXXX UNION SCHOOL DISTRICT REQUEST FOR MATERNITY LEAVE SICK PAY OR EXTENDED DISABILITY COMPENSATION FROM: DATE: (Print Name) SCHOOL: I request that I be paid sick leave pay and/or extended disability pay for the following reasons stated by my physician. I realize that I may claim sick leave pay and/or disability pay for no more than that limited period of time when I am physically disabled from performing my duties because of pregnancy, miscarriage or recovery. This leave is not intended to provide for periods of rest prior to or following childbirth, or for childcare. Employee Signature