Victoriano Attendance Verification
Student Absence E-Verification Form
* Required
Students First and Last Name
*
Your answer
Students Grade
*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Date of Birth
*
MM
/
DD
/
YYYY
Date(s) Student was Absent - List all dates
*
Your answer
Reason For Absence
*
Choose
Doctor Or Dentist Appointment (submit proof whenever possible) - Excused
Illness - Excused
Student Court Appointment (submit proof to the office) - Excused
Religious Observance 9total allowed per year is 3 days) - Excused
Funeral Bereavement - Immediate Family Only - Excused
Personal / Family Emergency - Unexcused
Transportation Problems - Unexcused
Other Reason - Unexcused
If you selected funeral/bereavement, indicate the relationship of deceased to student (immediate family only)
Your answer
If Other, what was the reason (not excused)
Your answer
Parent or Guardian Name
*
Your answer
Parent or Guardian Email Confirmation
*
Your answer
Parent or Guardian Phone Number
*
Must match what we have on file.
Your answer
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