Attendance Reporting Form/Formulario de Informe de Asistencia 
District policy is 48 hours to excuse an absence.  If your student is planning an absence for 3 or more days in length please fill out a Pre-arranged Absence Form. If your student believes they were marked incorrectly in a class they need to talk to the teacher.  
  1 student per form.  THIS FORM IS FOR PARENT OR GUARDIAN USE ONLY.
Email *
Parent/Guardian First and Last Name 
Nombre y apellido del padre/tutor
*
Student First and Last Name /Nombre y apellido del estudiante *
Phone number
Numero de telefono
*
Type of absence  
Tipo de ausencia
*
Student ID number/Número de identificación del estudiante
Start Date/Fecha de inicio *
MM
/
DD
/
YYYY
End Date/Fecha final
MM
/
DD
/
YYYY
Start and End time of absence 
Hora de inicio y fin de la ausencia
*
Reason for Absence or Tardiness/
Motivo de la ausencia o tardanza
*
Other Reason for Absence/Otro motivo de ausencia
Do you want to be contacted about this absence?
¿Quiere ser contactado acerca de esta ausencia?
Clear selection
Do you want a note sent to the student letting the teacher know they need to leave today?
Clear selection
A copy of your responses will be emailed to .
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of 4j.lane.edu.

Does this form look suspicious? Report