JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Farley Elementary School: Absence Note/Nota de Ausencias/Nòt Absans
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Date/ Fecha/ Dat:
*
MM
/
DD
/
YYYY
Student's Name/ Nombre del Estudiante/ Non Elèv la
*
Your answer
Grade/ Grado/ Klas:
*
4
5
6
Date(s) of absence/ Fecha(s) de ausencia/ Dat (yo) absans
*
Your answer
Reason for absence/ Razon de le ausencia/ Rezon pou absans
*
Personal illness/ Enfermedad personal/ Maladi pèsonèl
COVID positive/ COVID positivo/ COVID pozitif
Illness or death in family/ Enfermedad o muerte en la familia/ Maladi oswa lanmò nan fanmi an
Impassable roads or weather/ Carreteras intransitables o clima/ Wout enfranchisabl oswa move tan
Religious observance/ Observancia religiosa/ Obsèvans relijye
Required court appearance/ comparecencia ante el tribunal requerida/ Prezans nan tribinal obligatwa
Medical appointment/ Cita medica/ Randevou medikal
Circumstances related to homelessness/ Circunstancias relacionadas con la falta de vivienda/ Sikonstans ki gen rapò ak sanzabri
Other/ Otro/ Lòt
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of North Rockland Central School District.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report
