This form must be completed and approved by the Manalapan-Englishtown Regional Schools Board of Education prior to the leave of absence. As per Policy 3431/4431, unauthorized leave shall constitute a breach of contract and, therefore, may result in the initiation of dismissal procedures, loss of salary, or such disciplinary actions as may be deemed appropriate.

1. 1. Employee completes form and signs.
   2. Employee attaches supporting documentation for the requested leave.
   3. Immediate Supervisor completes and signs.
   4. Once completed, form is sent to Melina Ardizzone, Confidential - Secretary - HR Staff Registrar, or email mardizzone@mersnj.us.
   5. Employee will be notified of the Board’s action via email.
   6. If approved, the Human Resources Department will update your attendance record to reflect the days.