Please complete this form anytime your student is absent from school.
Student's Name (Last, First)
Date(s) of Absence(s) (MM/DD/YYYYY)
Please enter start and end date if the absence is for multiple consistent days
Reason for Absence
Excused- Injury or Illness (Documentation may be required)
Excused- Medical or Dental Appointment (Please provide Drs note to Office)
Excused-Director Approved Educational Leave
Excused-Court or Administrative Proceedings(Documentation may be required)
Excused- Death in the Family
Parent Name (E Signature)
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This form was created inside of FernLeaf Community Charter School.
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