Sign in to Google to save your progress. Learn more
Student Last Name: *
Student First Name: *
Date of Absence *
MM
/
DD
/
YYYY
Absence Type *
Reason For Absence *
If your student tested positive for COVID-19, please enter the date they tested positive below so staff can determine their return to school date.
Multiple Day Absence? *
Multiple Day Absence Start Date
MM
/
DD
/
YYYY
Multiple Day Absence End Date
MM
/
DD
/
YYYY
My student attends Dry Creek's ELOP Afterschool Program. *
Name of Person Reporting Absence *
Relationship to Student *
Email Address of Person Reporting Absence *
Note: Email address subject to verification with student record.
Contact Phone Number *
Electronic Signature and Acknowledgement *
By entering my name below, I attest that I am the parent/guardian of the above-named student and all the information provided is accurate.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Dry Creek Jt Elementary School District. Report Abuse