AFSCME REQUEST FOR TIME OFF
Fraser Public Schools
Employee Name:
*
First Name
Last Name
Employee Email:
*
example@example.com
Building:
*
Please Select
Administration Building-HR Dept
Administration Building-Business Office/Finance
Administration Building-Special Education Dept
Disney
Dooley
Edison
Eisenhower
Emerson
FHS
FHS -Athletic Wing
O & M
RMS
Salk
Transportation
Twain
Substitute Arranged:
*
Please Select
YES-I have arranged my sub
YES - Please find me a sub
NO -A sub is not needed
If Yes, Name of Substitute:
Bargaining Group:
*
Administrative Assistant
Food Service
Media Tech Assistant
O and M
Transportation
How many months do you work in a year?
*
I work 10 months in a year
I work 11 months in a year
I work 12 months in a year
*How many months do you work in a year?
*
I work 10 months in a year
I work 12 months in a year
*
I am Administrative Assistant-CTE
I am Administrative Assistant -Student Count
Request for Time Off
*
Requested Time Off
*
**Please note the pull down calendar week runs from Monday to Sunday**
Bereavement relation if applicable:
THIS FIELD MUST BE FILLED OUT IF BEREAVEMENT IS SELECTED
Additional Information:
Employee Signature:
*
Please type first and last name
Submit
Should be Empty: