Report An Absence Form
Submitting this form will alert the office that your child is absent. It will also serve as an excuse note for the absence. For multiple days absent please fill out the NOTE section at the end of this form.
* Required
Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Grade Level
*
Choose
K
1
2
3
4
5
Teacher's Name
*
Your answer
Date of Absence
*
MM
/
DD
/
YYYY
Please provide a reason for this absence.
*
Your answer
Parent/Guardian First Name
*
Your answer
Parent/Guardian Last Name
*
Your answer
Parent/Guardian Contact Phone Number
*
xxx-xxx-xxxx
Your answer
Notes for reporting multiple absences
Your answer
I certify that I am the parent or legal guardian of this student and am authorized to submit this information.
*
Yes
Required
Submit
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