Excused Absence Reporting
Excused Absence Reporting
Students FIRST and LAST name:
*
Student Number
*
Must be a number less than or equal to
999999
.
Grade
*
Grade
9th
10th
11th
12th
Date of ABSENCE - Not birthday of the student
Date of ABSENCE - Not birthday of the student
*
/
MM
/
DD
YYYY
If your request for an excused absence was for class periods within a single day, not the entire day, which class periods did this student miss?
If your request for an excused absence was for class periods within a single day, not the entire day, which class periods did this student miss?
ALL DAY
1st
2nd
3rd
4th
5th
6th
7th
Parent/Guardian phone number where you can be reached during the day.
Parent/Guardian phone number where you can be reached during the day.
*
-
###
-
###
####
Parent/Guardian Email Address
*
Reason for absence
*
Illness of student
Major illness in the immediate family of the student
Death in the immediate family of the student
Religious holiday of the student's faith
Religious instruction
Subpoena or forced absence by any law enforcement agency. A copy of the subpoena or court summons must be sent to the school
Brief description
Upload documentation
Attach Files
Parent/guardian please draw your signature into the box below.
*
Draw
or
Type
I understand this is a legal representation of my signature.
Clear
Full Name
I understand this is a legal representation of my signature.
Spam Protection. Please answer this simple question:
5, 6, 7, 8 : the 4th number is?