Kaw Valley Unified School District #321

411 W. Lasley St. Marys, KS 66536 / Phone: 785.437.2254
TEACHER PROFESSIONAL LEAVE REQUEST
Instructions:  Complete form, print, and sign; turn in five days prior to request.

 

TO:   & Mr. Kerry Lacock, Building Leader & Superintendent

 

FROM:  (Teacher's Name)

 

This is a request to take Professional leave on (or beginning):

If other please specify: 

 

Month: Day:  Year: 
 

Please state reason for Professional Leave:

 

 

 

Please Select One:

 

 

If leave is multiple days, please indicate the number of days requested: 

 

Teacher's Signature _____________________________________________________
 

 

Building Principal

____________________________________

 

Superintendent

____________________________________