Request for Professional Leave

REQUEST FOR PROFESSIONAL LEAVE

 PROFESSIONAL LEAVE (Code 7; EBS 870): DATE(s)______

REASON: ( refer to Educational Agreement )______

______

 CENTRAL REQUIRED LEAVE (Code 10; EBS 874): DATE(s)______

REASON: (refer to Educational Agreement)______

______

 Participant  Trainer

REASON:  Joint Committee  Accompanying Students on School Related Activities  System-Wide Initiative  Other (requires detailed justification)  Official Representative of School System

Description of Activity (use specific workshop/activity title):______

______

 Substitute Required  Substitute Not Required

______Date School/Location Person Requesting Leave (Print Name)

______Signature of Person Requesting Leave

______Approved Not Approved ______Date Director of Professional Learning

______Approved Not Approved ______Date Assistant Superintendent of Federal Programs