Master Agreement 2005 - State Employment Relations Board

Absence Certification Form
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DAILY EMPLOYEE'S ABSENCE
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COLUMBUS PUBLIC SCHOOLS
REPORT OF EMPLOYEE ABSENCE
Ob~ form 11\tiSl be sigool. arnl return«! ro ~oo rpri neipil or imlne.liare ~~l'ft"iSOr "'llllin tb~days
from lh 1asl dayoh~n,rontr~:~: days after tbedose oh sdlool ytn, whicbevn oa:;u~ r.ut.)
Date absence began (month) ___ (day) _ __ (yr) ___ (time) __ _
Lastdateofabsence(month) ___ (day) _ __ (yr) ___ (time) _ _ _ Number of days _ _ _
Assigned Building(s) p.m.
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