DEMANDE DE CONGE POUR FORMATION SYNDICALE Référence : décret n° 84-474 du 15 juin 1984
Circonscription :
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NOM – Prénom
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Ecole
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Classe
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Date et heure du début de l’absence
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….. h …
Date et heure de la fin de l’absence
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….. h …
Durée de l’absence
……. jour(s)
Je soussigné(e), sollicite une demande de congé pour formation syndicale afin de participer à …………………………………………. (convocation syndicale à joindre). Date et signature ……………………………
N.B. (réf. article 3 du décret ci-référencé) : la demande de congé doit être réceptionnée par écrit par l’IEN de la circonscription au moins un mois à l’avance.
Avis du directeur de l’école précisant la façon dont l’accueil et l’enseignement seront assurés : ………………………………………………………………………………………………………… ………………………………………………………………………………………………………… ………………………………………………………………………………………………………… Date et signature ……………………………. Avis obligatoire de l’IEN de circonscription :
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