Csea Vacation Request Form printable pdf download

CSEA

Vacation Request Form

(Submit along with an Employee Absence Form)

Name:

_____________________________________________ Site/Dept: ______________________

Please be aware that based on an MOU recently signed between the District and CSEA, vacation request

requirements have changes. The following vacation guidelines now apply:

For the rest of the 2013-14 school year, CSEA unit members may:



submit requests for vacations of more than three (3) consecutive days in length to the unit members’ direct

supervisor at least thirty (30) days in advance

submit requests for vacations of one, two, or three consecutive days in length to the unit members’ direct

supervisor at least ten (10) days in advance

if an emergency situation arises, submit requests for vacation of any length at any time, knowing that such

requests may be approved or denied at the sole discretion of the District

Beginning with vacations requested for the 2014-15 school year, current contract language will be enforced,



and requests for 3 or more days of vacation to be taken during the 2014-15 school year will need to be

submitted by May 30, 2014, and requests for one or two days of vacation to be taken during the 2014-15 school

year will need to be submitted at least ten days in advance.

My personal records reflect that I have ______ days of vacation time accrued as of today’s date and that I accrue an

additional ______ days of vacation time per month.

_____ I hereby request the following vacation(s) of less than three (3) consecutive days scheduled at least 10 days

days from now, as listed below.

_____ I hereby request the following vacation outside of the above timelines because of an emergency situation as

listed below. I have described the emergency in the comments section, and I have attached additional

documentation to support my need for emergency vacation leave.

_____ It is before May 30, and I hereby request the vacation(s) of three (3) or more consecutive days for the

following school year, as listed below

Dates Requested

Number of Days Requested

Comments (optional):

Employee Signature ____________________________________________

Date ___________________

Supervisor Approval of Requested Dates ____________________________

Date __________________

Human Resources Approval ______________________________________

Date __________________

After supervisor approval is given, please make a copy for your records and submit this form to Human Resources

according to the timelines above.

Csea Vacation Request Form