Northridge Bands Absence Request
Student Name: *
Your answer
Date of Absence: *
MM
/
DD
/
YYYY
Type of Absence: *
If arriving late, what time will you arrive?
Time
:
If leaving early, what time do you need to leave?
Time
:
Reason for absence? *
Please provide more details about your choice above. If a family vacation or doctor's appointment, please provide the time in addition to the date of the event. If there is a conflict with another activity, please list the activity and explain the times that conflict.
Your answer
Electronic Parent Signature: *
Your answer
Email address for director to contact you to discuss the status of this absence request if necessary. *
Your answer
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