NMCSC Personal Absence Request Form

Form due to Central Office prior to the requested dates, except for sick days or family illness.

First Name *

Last Name *

Employee email address *

Choose your home school or department *

Frontline (formally AESOP) Confirmation # 🛈

Will this absence require a substitute? *

Please choose your supervisor *

Alternate Email

Start date * +

End date * +

Please choose the pay period(s) when absence occurs: *

Number of full days off
*

Number of half days off
*

Is half day(s) AM or PM? *

Reason for request *

If bereavement, please choose from the following *

If without pay, please choose one of the following *

If other, please explain *

Is request due to FMLA? *

Yes

No

Comments

Employee Signature *

clear