Victoriano Attendance Verification
Student Absence E-Verification Form
Students First and Last Name
Date of Birth
Date(s) Student was Absent - List all dates
Reason For Absence
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)
If Other, what was the reason (not excused)
Parent or Guardian Name
Parent or Guardian Email Confirmation
Parent or Guardian Phone Number
Must match what we have on file.
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