SCBOWBO

Leave of Absence Request

Season leave requested for (fill in date range):

   200_   -   200_

Name of official requesting leave: _______________________

Address: __________________________________________________________

City: ____________________________ State: _______ Zip: ______________

Phone Number: ( ) ______________________

Date of Request: __________________

*** NOTE: The Board of Directors must receive the request in writing
by December 1 of the present season.

Please state the reason for requesting a leave of absence: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________