Attendance Verification Form
*****USE FOR FULL DAY ABSENCES ONLY******

Please Note: All fields marked with a red asterisk are required fields.

To be completed by parent/legal guardian only.

Will the student be absent for an ENTIRE day or a PARTIAL day?
Student First Name
Your answer
Student Last Name
Your answer
Grade
Student ID Number
In this box, please type your child's Student ID Number. (Not Required)
Your answer
Your name
In this box, please type YOUR first and last name.
Your answer
Email Address
In this box, please type YOUR email address. Please note that only email addresses on file with your student's assistant principal will be accepted for excused absences. (Not Required)
Your answer
Acknowledgement
Please check yes below to acknowledge the following statement: "By checking the signature box, I certify that I am the legal guardian of this child and all of the information provided to Livonia Pubic Schools School District is accurate"
Required
Reason for Absence
Please select the reason for your child's absence from the list below. This data is required by county regulations.
Is the reason for absence due to a communicable disease?
If not, select "No." Otherwise, please select the disease your child has been diagnosed with. This question is required to comply with county standards.
Date of Absence
If absence is multiple dates, please select the first absence date.
MM
/
DD
/
YYYY
Multiple Day Absence Ends
If absence is multiple dates, please select the LAST ABSENCE date.
MM
/
DD
/
YYYY
Submit
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