Request for Professional Leave Form

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					                 RANDOLPH COUNTY BOARD OF EDUCATION

          REQUEST TO BE ABSENT FOR PROFESSIONAL REASONS


I, ___________________________, a teacher at ___________________ school, request
approval to be absent for professional reasons for a total of _____ days as follows:

(Circle one)
Full Day       Half Day               Month________ Day _______, _______
Full Day       Half Day               Month________ Day _______, _______
Full Day       Half Day               Month________ Day _______, _______


I understand I will receive full salary. The substitute that is employed in my classes on
the specific day(s) will be paid by____________________________________.


___________________________________                          ___________________
Teacher’s Signature                                          Date

___________________________________                          ___________________
Principal’s Signature                                        Date

___________________________________                          ___________________
Representative from responsible party                        Date

___________________________________                          ___________________
Cathy Brady                                                  Date

Make 2 copies and send to the Certified Personnel Office. One will be returned to the
teacher and one will go to Payroll.

				
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