PRESCOTT UNIFIED SCHOOL DISTRICT Optional Message: Last four digits of your Social Security Number (this is your digital signature): Name of Receiving Employee: Number of HOURS Donating: PROFESSIONAL/SUPPORT STAFF VOLUNTARY TRANSFER OF ACCRUED SICK LEAVE Fill in the fields below and click the submit button. A confirming email will be sent to you. Email Address of Employee Donating:

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I understand that the number of hours indicated above will be withdrawn from my sick leave balance and deposited into the receiving employee's sick leave account. No employee may receive more than 20 Employee to Employee donated days in any fiscal year. Date:

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If you have any questions regarding donation of days, please refer to PUSD Policy GCCGA, or email Maria Reed. FirstName.Lastname @prescottschools.com