​Extended Ed Counselor Absence Form

 
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* indicates a required field

Date(s) of Absence *


Enter date(s) of absence

Last Name *


Enter your last name

First Name *


Enter your first name

Email *


Enter your email address

Absent the whole day *


Comments


Additional Comments

Days/Hours Absent *


Ex: Monday 1-2:00 pm & 3-4:30 pm

Reason for Absence *


Choose a reason for your absence above (required)

EIN # (0123456) *


Enter your EIN# (available in MyShasta on your Pay Advices).

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