ABSENCE / VACATION REQUEST FORM - California Sports Center

CSC Location: ________________________
ABSENCE / VACATION REQUEST FORM
(Complete a separate page for each week affected)
Rules – Plan ahead & complete TWO WEEKS ahead of time.
#1. Remember that you are personally responsible for all of your classes. If you take time off, if you are sick, if a holiday falls
on one of your classes, etc., your class must be taken care of. Use the back of the form for additional days or weeks off that
will be affected.
#2. This form is due two weeks prior to the time you are requesting off. If you do not give at least two weeks notice, there is
a possibility that you might not be able to get subs for your requested time off. Please plan ahead for the best results.
#3. You are responsible to find your own substitutes. If unable to find a sub and appropriate notice was given you may
reschedule the class to another day or allow make-ups for your missed class at class times not already full. You must teach
the class and any change must be put in writing to the class one week before and you are required to call all the students in
the class with verbal reminder of the change. Changes in the regular schedule should be avoided and is ok only every 90
days. Please check with your site manager before canceling or re-scheduling any classes.
#4. After you initially complete the form, check with your primary manager and inform them of your intentions. They must
sign the form and date it for your proof that you filled it out at least two weeks in advance. This also gives them a chance to
tell you that the day requested may not be possible due to other requests already approved. Some days may not be approved
if already requested by other staff first, or if too short a notice is given. Once subs are found, after initial review by the
manager, return the completed form to the manager for final sign off and then post it on the Staff Info Board.
Name: ______________________
I am requesting the following days for (Check One):
Today’s Date:_____________
_____ 1. Personal Time Off
_____ 2. Required CSC Business
The days affected by this time off are: ____ ___ ___ ___ ___ ___ ___
(Check the days affected) Mon. Tue. Wed. Thu. Fri. Sat. Sun.
I will miss the following classes and have arranged for subs as noted:
Date/ Day Each Class (be specific) Time Substitute Subs Initials
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List additional days and classes on the back if still in the same week and check here ____.
Signed: ______________________________
Reviewed (before subs): _________________ Date Reviewed:______________
Final Approval (after subs): ______________ Date of Approval:_____________
Revised 10/12/10

Continued from the front
Date/Day Each Class (be specific) Time Substitute Subs Initials
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Check the appropriate area on the front if you listed any classes on this side.
Thank You.
Revised 10/12/10