This form is to report absences only, not to request students be released from class. It is NOT necessary to send an additional doctor's note unless the absence exceeds four days.
Students Legal Last Name *
Student's Legal First Name (no nicknames please) *
Student's Grade *
Required
Student ID #
Is this a partial day, single day or multiple day absence? *
Required
Date of single /partial day absence
MM
/
DD
First date of multiple day absence
MM
/
DD
Last date of multiple date absence
MM
/
DD
Reason for absence *
use pull down menu for options
Explanation
Name of parent/guardian reporting the absence *
(must be parent or guardian listed on the student's file)
Parent / Guardian phone number (listed on student file) *
Parent / Guardian email address (listed on student file) *
Verification of identity *
Required
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