Pre-Planned Absence Form (One Form per student)
APPLICATION FOR A STUDENT'S PRE-PLANNED ABSENCE:
Absence from school for student and/or parent personal convenience is not provided for under the school attendance laws of the State of Ohio. Therefore, the proposed absence will be considered
“UNEXCUSED” for state coding purposes. Parents/guardians are asked to complete this form to relieve the school of responsibility.
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Email *
Student's First and Last Name *
Student's Grade Level *
First Date Missing from School *
MM
/
DD
/
YYYY
Last Date of School Missed *
MM
/
DD
/
YYYY
State clearly and concisely the nature of this absence and the reason why the leave must be taken during the school year. *
My child has or will meet with every one of his/her teachers or emailed them to let them know of the days missed. *
Today's Date *
MM
/
DD
/
YYYY
I have read the following statement:  We understand that this absence from school for the reasons listed above is not provided for under the school attendance laws of the State of Ohio; that this absence will be “UNEXCUSED” but that by completing this form and fulfilling the requirements the student will be permitted to make up tests missed and will not be considered truant. We further understand that when a pupil returns from a pre-planned absence, teachers are not required to grade, examine, or correct any work done by the pupil during the absence. The school can assume no responsibility for drop in grades suffered by a pupil who is absent due to a pre-planned absence. Arrangements to make up tests must be made by the pupil by the second day he returns to school after a pre-planned absence oran “F” will be recorded for each test. All students are expected to be present for semester examinations. Teachers may (but are not required to) prepare assignments of a very general nature for pupils who are anticipating a pre-planned absence. It is the responsibility of the student to inform each teacher of the dates of this personal convenience absence in advance. *
Parent/Guardian e-Signature *
Parent/Guardian Daytime Phone number *
A copy of your responses will be emailed to the address you provided.
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