SAMPLE
XYZ Charter
719
555/555-1234
Please complete all information to assure the best communication with your substitute.
Teacher Name: ______________________________________________________________
Date Submitted: _____________________________________________________________
Date Substitute Needed: _______________________________________________________
Reason for Request: (circle one) Staff Development Personal/Sick Day
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Advisory Off-Period |
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Lesson plans and attendance sheets are located: _____________________________________
___________________________________________________________________________
Special request/instructions: ____________________________________________________
___________________________________________________________________________
Approved by: ________________________________________________________________
Substitutes Contacted: _________________________________________________________
___________________________________________________________________________
Substitute Confirmed: _________________________________________________________
Substitute’s Phone Number: ____________________________________________________
Contacted by: _________________________________ Date: _________________________
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