EMPLOYEE NAME: TREATYNUMBER:
POSITION: DEPARTMENT:
I request approval to take the following leave
Leave Without pay
Personal Leave with Pay
School Business
PD Leave
Band Committee Leave / School Leave
Compassionate Leave
Pressing Necessity
Bereavement Leave
Sick Leave
Other Leave
DATES: _________________ FROM: __________________________ TO: _____________________________
Total number of working days off:
If you are requesting sick leave or leave of absence, please explain below.
Signature of Employee Date
Approval
Refusal
Reason for refusal
Signature of Employee Date