Miami-Yoder School District JT-60 420 South Rush Road Rush, CO 80833 Employee’s Name _______________________________________________ Date(s) Applied for: ______________________________________________ Explanation surrounding the request and justification as to why an exception should be granted by the Board of Education: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Date of Submission to Superintendent: ________________________________________ As an employee, I agree that the decision of the Board of Education is final and that an appeal of that decision will not be granted. I also understand that I must expend all personal days of leave, before being granted leave under the classification of “sick leave.” Employee’s Signature: _____________________________________________________ Date: ___________________________________________________________________ XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX For Office …
Read Full Policy- Last Reviewed/Revised:
- Last Adopted: August 13, 2009