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Get NY OP 201

APPLICATION FOR EXCUSE OF ABSENCE WITHOUT PAY AND/OR AS NON-ATTENDANCE Community District Instructional Staff City District Instructional Staff SECTION I: TO BE COMPLETED BY SCHOOL SECRETARY OR APPLICANT Applicant's Full Name School Name Home Address School Address City State File# State City Zip Social Security Number Zip School District # License Years of Service Regularly Appointed N.B. Not used for per diem substitutes Regular Substitute Days Absent: Use "N" for days of .

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