Roxbury Central School Absence Reporting Form
DescriptionThis form may be used to report all excuses for tardiness, absences, or early dismissals. A phone call to
ext. 20, a written excuse, Dr’s. note or this form must be used for an excused absence. Parents are
requested to return this form filled out and signed as soon as their student returns to school. All reported absences must be documented within 48 hours after returning to school to be considered an excused absence
Email address *
Student's Name *
Grade *
Reporting for the following date/s *
Reason for report
Clear selection
Is to be dismissed at:
Legal Absence *
If "other" is selected please describe below. Any other absence must be cleared through administration to be considered excused
Name and contact information for person completing form *
A copy of your responses will be emailed to the address you provided.
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