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.
Student's First Name *
Student's Last Name *
Grade Level *
Teacher's Name *
Date of Absence *
MM
/
DD
/
YYYY
Please provide a reason for this absence. *
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Contact Phone Number *
xxx-xxx-xxxx
Notes for reporting multiple absences
I certify that I am the parent or legal guardian of this student and am authorized to submit this information. *
Required
Submit
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