Request for Leave – All School January 10, 2017 Flint Hill School This form must be completed if you will be missing at least a half day. If you will be out less than that, please inform your supervisor and sign in/out accordingly.Name of FHS Employee* First Last Email* Division (Select all that apply)* Upper School Middle School Lower School Admission Office Development Office Leadership Business Office Athletic Office Facilities Marketing & Communications Headmaster Office Information Technology Summer Programs/Aftercare College Counseling Security Amount of Leave Requested*Full DayHalf DayFull Day(s)From Date* To Date* Details (if needed)Half DayDate Time of DayMorningAfternoonDetails (if needed)Other Duties or helpful InformationPlease list/describe any non-teaching duties, including advisory, that will need coverage during your absence. Also use this space to provide any explanation or need in regard to your absesnce.Name of Substitute / Covering Faculty Member* First Last Enter first name followed by last name. If you do not need coverage, enter "NA."To whom will you send your substitute plans? First Last Skip this question if you answered "NA" above.Reason for LeavePersonal DayVacation DaySick Day (including the care of a family member or dependent)BereavementReligious HolidayProfessional DevelopmentFHS ActivityCommentsThis field is for validation purposes and should be left unchanged.