3049 - Vacation Request Form

                 VACATION REQUEST FORM    3049
Date of Request _________________________________
Employee Name ____________________________________________________
School _______________________________________________
Vacation Days Available _______________________________________
                                                    (To be filled in by district)  
Vacation Days Requested _____________________________________________
Dates ___________________________________________________
Substitutes Name ______________________________________________
                                (if vacation is taken while school is in session)
Employee Signature _____________________________________________________
Principals Approval ___________________________________    Date ________________
Superintendents Approval ______________________________    Date ________________

*Request must be submitted 2 weeks ahead of time.
*Vacation days must be used between July 1 to July 1 (fiscal year). It is recommended that vacation time be used during the summer months unless the employee has received special approval.
Days cannot be carried over into the next fiscal year.

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Piute County School District
500 North Main - P.O. Box 69
Junction, Utah 84740-0069
Phone: (435)-577-2912 - Fax: (435)-577-2561
© 2020 Piute County School District
Piute School District does not discriminate on the basis of race, color, national origin, sex, disability, or age in its programs. Please contact your school principal for further information.