Leave Request - Professional /academic Sponsor/Athletic Clinic

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LEAVE REQUEST-- PROFESSIONAL /ACADEMIC SPONSOR/ATHLETIC

CLINIC
____________________________________________________________________________________________
FULL NAME:
DATE(S) OF LEAVE
DATE SUBMITTED
____________________________________________________________________________________________
SCHOOL
GRADE AND/OR SUBJECT(S) TAUGHT

Criteria for Professional Leave Monday-Thursdays

While professional leave opportunity certainly can help to improve the overall effectiveness of a
teacher in the classroom, the loss of direct instructional time with students should be considered
carefully.
Thank you for reviewing the following criteria when applying for professional leave and
checking all that you feel meet your request. Your building principal will review this and determine
final approval status.
_____ Does the leave request directly relate to the school or district Unified Improvement Plan?
_____ Does the leave require training that is only offered on a Monday-Thursday?
_____ Does the leave require training that cannot be offered in-district with district level facilitators on
an
academy day?
_____ Does the leave request directly relate to an academic or club competition?
_____ Does the leave request relate to peer observations for coaching or improvement opportunities?
_____ Does the leave request directly relate to professional development around district adopted
resources
or curriculum?
_____ Does the training required in the leave request meet the No Child Left Behind definition of
effective
professional development? (classroom focused, job embedded, sustainable, skill or strategy
specific)
For athletic/coaching clinics, the following criteria should be weighed:
_____ Does the training/clinic directly relate to the athletic programs improvement?
_____ Is the training/clinic based on learning or developing specific athletic skills?
_____ Is the training/clinic only offered on a Monday-Thursday?
NAME OF ACTIVITY: _______________________________________________________________________
LOCATION OF ACTIVITY:____________________________________________________________________
TEACHER/STAFF SIGNATURE: _______________________________________________________________
Teacher Comments:

Principal Comments:

EMPLOYEE ABSENCE INFORMATION:


INFORMATION:

If a sub is needed: JOB/SUB

Start Date: ______________ Start Time:___________


Time:__________

Start Date: ____________ Start

End Date: ______________ End Time: ___________

End Date: _____________ End Time: __________

Sub Required: Yes _____ No ______ Specific Substitute Requested: ___________________________

No Sub Needed: ____________


NOTE: Substitutes are paid for a full day (7:30 AM until 4:00 PM),
or
half day (7:30 AM until 12:00 PM, or 12:00 PM until 4:00 PM).
Filled Within: ______________
Please enter these times in the JOB INFORMATION.
BUILDING AUTHORIZATION __________________________________ DATE____________________

Office use
only

DISTRICT OFFICE AUTHORIZATION ___________________________ DATE


___________________

Entered

9/2013

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