FORM Name: Today's Date: 10/12/04 Date of Request: 11/24/04 — 11/29/04 Total Number of Days: 5 days - 1 week day, 2 weekend days, 2 days in lieu Columbus & Thanksgiving, Please list a phone number where you can be reached while on vacation The following should be verified with the Principals How many vacation days

FORM Name: Today's Date: 10/12/04 Date of Request: 11/24/04 — 11/29/04 Total Number of Days: 5 days - 1 week day, 2 weekend days, 2 days in lieu Columbus & Thanksgiving, Please list a )hone number where \rnl can he reached while on vacation The following should be verified with the Principals How many vacation day