VACATION NOTIFICATION SLIP

________________________________________________________   WILL BE OFF THE                                                   
CHILD’S NAME

FOLLOWING WEEK(S)__________________________________________________________________

_________________________________                                                   ____________________________

PARENT/GUARDIAN SIGNATURE                                          DATE SUBMITTED

----------------------------------------------------------------------------------------------------
OFFICE USE ONLY

______________________________                                ________________________________                              

    # VACATION WEEKS USED                                 # VACATION WEEK AVAILABLE

VACATION  NOTIFICATION SLIP

________________________________________________________   WILL BE OFF THE                                                  
 CHILD’S NAME

FOLLOWING WEEK(S)__________________________________________________________________

_________________________________                                                   ____________________________

PARENT/GUARDIAN SIGNATURE                                          DATE SUBMITTED

----------------------------------------------------------------------------------------------------

Parent Copy

______________________________                                ________________________________                              

    # VACATION WEEKS USED                                 # VACATION WEEK AVAILABLE