Extended Student Absence Form
Complete the form for all students applying for an extended absence 𝟭𝟬 𝗼𝗿 𝗺𝗼𝗿𝗲 𝗰𝗼𝗻𝘀𝗲𝗰𝘂𝘁𝗶𝘃𝗲 𝗱𝗮𝘆𝘀 𝗳𝗼𝗿 𝗲𝗺𝗲𝗿𝗴𝗲𝗻𝗰𝗶𝗲𝘀 𝗼𝗿 𝗮𝗯𝘀𝗲𝗻𝗰𝗲 𝗳𝗿𝗼𝗺 𝘁𝗼𝘄𝗻. You will receive an email after the Superintendent has reviewed your request.

If you need to apply for an extended student absence for a different reason (e.g., medical reason), contact your school directly and DO NOT complete this form.
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Email *
Name of Student(s) *
Include all students' names.
Name of Parent Completing Form *
School *
Required
Grade *
Required
Dates Requested as Excused *
Number of Days Requested *
Complete this form if you are requesting 10 or more consecutive days absence. Speak to your principal if you need to request fewer than 10 days' absence.
Reason for Request *
Your reason should include details about your travel.
Parent Name *
Your typed name is your signature.
Date *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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