PERSONAL LEAVE REQUEST FORM. This Appendix has been moved to the Licensed Employees’ Handbook (May 2015) PCC CHARGES
PERSONAL LEAVE REQUEST FORM. This Appendix has been moved to the Licensed Employees’ Handbook (May 2015) PCC CHARGES – 2017-18 SCHOOL YEAR
PERSONAL LEAVE REQUEST FORM. Employee’s Name: Date: Date(s) of requested leave: I CERTIFY THAT I AM USING PERSONAL LEAVE IN ACCORDANCE WITH ARTICLE 8, PARAGRAPH B OF THE AGREEMENT FOR THE FOLLOWING REASON*: Major disaster affecting immediate family property Closing of loans on property Court appearance Wedding of employee Immediate family receiving awards Immediate examination for military service Any business activity of major significance which cannot be handled before or after school or on a weekend Other (specify): *Additional information may be required if valid reason exists for questioning. Employee’s signature: Date: Approved Not Approved Supervisor Approved Not Approved Superintendent ADMINISTRATIVE USE ONLY: Replacement Needed Replacement Approved Yes Yes No No APPENDIX 4 ASSAULT LEAVE REPORT FORM Employee’s Name: Date of Assault: Location: Describe the assault: Describe any physical injury: Describe any pre-existing conditions and/or illness: State the name and address of all physicians which you have been treated by for the condition arising from the alleged assault and the dates that you were treated by each physician: List the names of witnesses to the assault: Did you file a police report? If a police report was filed, state the name of the law enforcement agency, the date of filing, and attach a copy of the police report: I hereby certify that the requested assault leave is not being used in violation of the Agreement, Article 8, Paragraph E, Assault Leave. Employee’s signature: Date: APPENDIX 5
PERSONAL LEAVE REQUEST FORM. The intent of Personal Leave is to allow employees time for business or personal commitments that cannot be scheduled at any time other than during a work day. An employee may request Personal Leave as specified in the appropriate bargaining unit’s contract. The Personal Leave Request Form is to be sent directly to the Superintendent. If your request is NOT approved, you will be notified. Personal Leave may not be taken on the days immediately before or after a vacation period, holiday weekend, or holiday. The Superintendent may make exceptions. Such decisions are not subject to the grievance procedure. Personal Leave requests must be submitted at least forty-eight (48) hours in advance. Exemption may be made in cases of emergencies. The purpose of this Personal Leave request is to attend to business or personal commitments that necessitate my presence and cannot be taken care of at any time other than during the regular workweek. Employee Name (Please Print) Employee Signature Date of Request School Building Date(s) Requested (Day(s) of the Week Approved: Not Approved: Superintendent of Schools or Designee Date APPENDIX E
PERSONAL LEAVE REQUEST FORM. Employee’s Name: Date: Date(s) of requested leave: I CERTIFY THAT I AM USING PERSONAL LEAVE IN ACCORDANCE WITH ARTICLE 8, PARAGRAPH B OF THE AGREEMENT FOR THE FOLLOWING REASON*: Major disaster affecting immediate family property Closing of loans on property Court appearance Wedding of employee Immediate family receiving awards Immediate examination for military service Any business activity of major significance which cannot be handled before or after school or on a weekend Other (specify): *Additional information may be required if valid reason exists for questioning. Employee’s signature: Date: Approved Not Approved Supervisor Approved Not Approved Superintendent ADMINISTRATIVE USE ONLY: Replacement Needed Replacement Approved Yes Yes No No
