Common use of Date Received Clause in Contracts

Date Received. E. Disposition by the appropriate administrator or Joint Grievance Committee: (attach additional pages if necessary) Signature Date Name Date In accord with Article VI, Sec. B of the Negotiated Agreement, I hereby request a Sick Leave Grant of days (contract days) for the following condition: Dates I expect to be (or have been) disabled: I have exhausted all my Accumulated Sick Leave (yes or no): Signature of Employee (or other family member-in case of necessity) SICK LEAVE POOL : Grant applications are made by submitting a letter of request to a member of the sick leave pool committee. The applicant must have exhausted all accumulated sick leave. The applicant must demonstrate that a catastrophic or disabling condition exists. The grant application must be made within the contracted year that the condition occurs. The sick leave pool committee shall be the final authority on each grant. The applicant agrees to repay the Sick Pool under the guidelines stated in the Negotiated Agreement. If the applicant leaves the district, still owing days to the Sick Pool, the applicant agrees to a salary deduction at the daily rate during the year they leave the district for each day owed. If the applicant is disabled as evidenced by KPERS disability approval, reimbursement is not expected. Following for Use of Sick Leave Pool Committee: Do not Detach. Name Date Received by Committee Number of Sick Leave Days Accumulated at Beginning of School Year Date Sick Leave Days Exhausted Request Approved for Grant of Contract Days from the Sick Leave Pool. Request Denied: Reason Denied Date Approved or Denied by Committee Signature of Sick Leave Pool Committee Chairperson: School: Educator Name: Grade or Subject: Evaluator: Date: Time in: Time out: ○ Formal Evaluation/Observation Type of Evaluation: ○Summative Evaluation ○Informal Observation Number of Students: ○ Educator Self Reflection Instructions: The evaluating administrator shall complete this part of the Educator evaluation based on the 4 Elements of Effective Evaluation. Space may be adjusted as needed. This evaluation is based on the following written observations and/or other data. This form is to be completed electronically. Lesson Objective (Educator created): Description: Element 1: The Learner: Effective Educators carry high expectations for their students and develop lessons that will engage and challenge their students. Their classrooms are places where positive interactions occur between Educator and student and between student and student. The Educator understands how their students’ learning develops and plans instruction that is appropriate and individualized for instruction. The effective Educator creates a safe, respectful, and academically challenging classroom for their students.

Date Received. E. Disposition by the appropriate administrator or Joint Grievance Committee: (attach additional pages if necessary) Signature Date Name Date In accord with Article VI, Sec. B of the Negotiated Agreement, I hereby request a Sick Leave Grant of days (contract days) for the following condition: Dates I expect to be (or have been) disabled: I have exhausted all my Accumulated Sick Leave (yes or no): Signature of Employee (or other family member-in case of necessity) SICK LEAVE POOL : Grant applications are made by submitting a letter of request to a member of the sick leave pool committee. The applicant must have exhausted all accumulated sick leave. The applicant must demonstrate that a catastrophic or disabling condition exists. The grant application must be made within the contracted year that the condition occurs. The sick leave pool committee shall be the final authority on each grant. The applicant agrees to repay the Sick Pool under the guidelines stated in the Negotiated Agreement. If the applicant leaves the district, still owing days to the Sick Pool, the applicant agrees to a salary deduction at the daily rate during the year they leave the district for each day owed. If the applicant is disabled as evidenced by KPERS disability approval, reimbursement is not expected. Following for Use of Sick Leave Pool Committee: Do not Detach. Name Date Received by Committee Number of Sick Leave Days Accumulated at Beginning of School Year Date Sick Leave Days Exhausted Request Approved for Grant of Contract Days from the Sick Leave Pool. Request Denied: Reason Denied Date Approved or Denied by Committee Signature of Sick Leave Pool Committee Chairperson: School: Educator Name: Grade or Subject: Evaluator: Date: Time in: Time out: Type of Evaluation: ○ Formal Evaluation/Observation Type of Evaluation: ○Summative Evaluation ○Informal Observation ○ Educator Self Reflection Number of Students: ○ Educator Self Reflection Instructions: The evaluating administrator shall complete this part of the Educator evaluation based on the 4 Elements of Effective Evaluation. Space may be adjusted as needed. This evaluation is based on the following written observations and/or other data. This form is to be completed electronically. Lesson Objective (Educator created): Description: Element 1: The Learner: Effective Educators carry high expectations for their students and develop lessons that will engage and challenge their students. Their classrooms are places where positive interactions occur between Educator and student and between student and student. The Educator understands how their students’ learning develops and plans instruction that is appropriate and individualized for instruction. The effective Educator creates a safe, respectful, and academically challenging classroom for their students.

Date Received. E. Disposition by the appropriate administrator or Joint Grievance Committee: (attach additional pages if necessary) Signature Date Name Date In accord with Article VI, Sec. B of the Negotiated Agreement, I hereby request a Sick Leave Grant of days (contract days) for the following condition: Dates I expect to be (or have been) disabled: I have exhausted all my Accumulated Sick Leave (yes or no): I am requesting leave due to being physically assaulted in the course of my job that xxxxxxx’x comp does not cover (yes or no): Signature of Employee (or other family member-in case of necessity) SICK LEAVE POOL : Grant applications are made by submitting a letter of request to a member of the sick leave pool committee. The applicant must have exhausted all accumulated sick leave. The applicant must demonstrate that a catastrophic or disabling condition exists. The grant application must be made within the contracted year that the condition occurs. The sick leave pool committee shall be the final authority on each grant. The applicant agrees to repay the Sick Pool under the guidelines stated in the Negotiated Agreement. If the applicant leaves the district, still owing days to the Sick Pool, the applicant agrees to a salary deduction at the daily rate during the year they leave the district for each day owed. If the applicant is disabled as evidenced by KPERS disability approval, reimbursement is not expected. Following for Use of Sick Leave Pool Committee: Do not Detach. Name Date Received by Committee Number of Sick Leave Days Accumulated at Beginning of School Year Date Sick Leave Days Exhausted Request Approved for Grant of Contract Days from the Sick Leave Pool. Request Denied: Reason Denied Date Approved or Denied by Committee Signature of Sick Leave Pool Committee Chairperson: School: Educator Name: Grade or Subject: Evaluator: Date: Time in: Time out: ○ Formal Evaluation/Observation Type of Evaluation: ○Summative Evaluation ○Informal Observation Number of Students: ○ Educator Self Reflection Instructions: The evaluating administrator shall complete this part of the Educator evaluation based on the 4 Elements of Effective Evaluation. Space may be adjusted as needed. This evaluation is based on the following written observations and/or other data. This form is to be completed electronically. Lesson Objective (Educator created): Description: Element 1: The Learner: Effective Educators carry high expectations for their students and develop lessons that will engage and challenge their students. Their classrooms are places where positive interactions occur between Educator and student and between student and student. The Educator understands how their students’ learning develops and plans instruction that is appropriate and individualized for instruction. The effective Educator creates a safe, respectful, and academically challenging classroom for their students.

Date Received. E. Disposition by the appropriate administrator or Joint Grievance Committee: (attach additional pages if necessary) Signature Date Name Date In accord with Article VI, Sec. B of the Negotiated Agreement, I hereby request a Sick Leave Grant of days (contract days) for the following condition: Dates I expect to be (or have been) disabled: I have exhausted all my Accumulated Sick Leave (yes or no): Signature of Employee (or other family member-in case of necessity) SICK LEAVE POOL : :‌ Grant applications are made by submitting a letter of request to a member of the sick leave pool committee. The applicant must have exhausted all accumulated sick leave. The applicant must demonstrate that a catastrophic or disabling condition exists. The grant application must be made within the contracted year that the condition occurs. The sick leave pool committee shall be the final authority on each grant. The applicant agrees to repay the Sick Pool under the guidelines stated in the Negotiated Agreement. If the applicant leaves the district, still owing days to the Sick Pool, the applicant agrees to a salary deduction at the daily rate during the year they leave the district for each day owed. If the applicant is disabled as evidenced by KPERS disability approval, reimbursement is not expected. Following for Use of Sick Leave Pool Committee: Do not Detach. Name Date Received by Committee Number of Sick Leave Days Accumulated at Beginning of School Year Date Sick Leave Days Exhausted Request Approved for Grant of Contract Days from the Sick Leave Pool. Request Denied: Reason Denied Date Approved or Denied by Committee Signature of Sick Leave Pool Committee Chairperson: School: Educator Name: Grade or Subject: Evaluator: Date: Time in: Time out: Type of Evaluation: ○ Formal Evaluation/Observation Type of Evaluation: ○Summative Evaluation ○Informal Observation ○ Educator Self Reflection Number of Students: ○ Educator Self Reflection Instructions: The evaluating administrator shall complete this part of the Educator evaluation based on the 4 Elements of Effective Evaluation. Space may be adjusted as needed. This evaluation is based on the following written observations and/or other data. This form is to be completed electronically. Lesson Objective (Educator created): Description: Element 1: The Learner: Effective Educators carry high expectations for their students and develop lessons that will engage and challenge their students. Their classrooms are places where positive interactions occur between Educator and student and between student and student. The Educator understands how their students’ learning develops and plans instruction that is appropriate and individualized for instruction. The effective Educator creates a safe, respectful, and academically challenging classroom for their students.