Fillable YCCD Certificate of Absence

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YCCD Certificate of Absence

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The YCCD Certificate of Absence form is 1 page long and contains:

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  • 12 check-boxes
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Country of origin: US
File type: PDF

U.S.A. forms for Yosemite Community College District

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YOSEMITE COMMUNITY COLLEGE DISTRICT
Human Resources Operations
CERTIFICATE OF ABSENCE FOR MANAGEMENT STAFF
Name of Employee ___________________________________ Colleague ID #______________
(PRINT LEGAL NAME)
Dept. _____________ Check: MJC CC CS Month/Year ____________
LIST TOTAL HOURS ABSENT:
Sick Leave _____________________________
Vacation _____________________________
Pay Dock _____________________________
Other _
________________________________
• Bereavement (include relationship to deceased)
• Community Service (not to exceed 3 days)
• Jury Duty/Court Appearance (attach supporting form and check for
paid services)
• Professional Education (Board approval required)
• Personal Leave
•
Military
Floating Holiday ______________________
Personal Necessity _
____________________
Personal Business ____________________
Up to two (2) days of Personal Necessity Leave may be used for absences
as a result of personal business.
Extended Sick _______________________
Attach medical certification
Workers Comp ________________________
Attach medical certification
ITEMIZE DATES & HOURS ABSENT EACH DAY (Please do a separate form each month)
DATE(S)
MO/DT/YEAR
HOURS
(rounded to
nearest 1/4 hr)
LEAVE TYPE
Comments:
Employee Signature Date
Forward signed original to Human Resources Operations.
Please make a copy for your records.
Immediate Management Supervisor Date
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YCCD Certificate of Absence

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Completed 10 April 2020

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