Number of Additional Paid Hours

Number of Additional Paid Hours

Number of Additional Paid Hours

CONTRACT, SECTION 9.14

Check One

1.0 FTE

.900 FTE

.800 FTE

.700 FTE

.600 FTE

.500 FTE

.400 FTE

.300 FTE

.200 FTE

[ ]

6 release days

N/A

[ ]

5 release days

7.5 hours

6.75 hours

6 hours

5.25 hours

4.5 hours

3.75 hours

3 hours

2.25 hours

1.5 hours

[ ]

4 release days

15 hours

13.5 hours

12 hours

10.5 hours

9 hours

7.5 hours

6 hours

4.5 hours

3.0 hours

[ ]

3 release days and

22.5 hours

20.25 hours

18 hours

15.75 hours

13.5 hours

11.25 hours

9 hours

6.75 hours

4.5 hours

[ ]

2 release days

and

30 hours

27 hours

24 hours

21 hours

18 hours

15 hours

12 hours

9 hours

6 hours

[ ]

1 release day

and

37.5 hours

33.75 hours

30.00 hours

26.25 hours

22.5 hours

18.75 hours

15 hours

11.25 hours

7.5 hours

[ ]

0 release days

and

45 hours

40.5 hours

36 hours

31.5 hours

27 hours

22.5 hours

18 hours

13.5 hours

9 hours

* If choosing hours, please circle the amount for your time sheet based on your FTE. OR,

** If you want a specific substitute requested, you must list their name on this form

Preference for release days (dates and sub name)

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Employee Name (printed) Assignment (teacher, SLP, OT/PT, Psych)

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Employee Signature Building

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Date FTE

IMPORTANT: Please return this form to Special Services as soon as possible. ATTN: Donna Moran