Reporting an absence/ Reportando una ausencia

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Parent or Guardian must fill out the form/ Un padre o guardian debe completar el formulario. Llene una forma para cada estudiante.

Student Name/ Nombre de estudiante: *

Reason for Absence/Razón por Ausencia *

Fever/ Fiebre

Cough/ Tos

Stomach Ache/ Dolor de estomago

Headache/ Dolor de cabeza

Throwing up/ Vómito

Covid Positive / Resultados positivos de Covid

Exposed to a Covid positive case/ Expuesto a alguien positivo de Covid

Other-If other please, explain why in the next section. Otro- Explica la razón en la próxima area

Grade and Teacher/ Grado y maestro *

Transitional Kinder/Ms. Wong/Room 103

Kinder: Ms. Herrera, Room/Salón 106

Kinder: Ms. Fiz, Room 104

Kinder/First: Mr. Lopez, Room 105

First Grade: Ms. Metro, Room 205

First Grade: Ms. Cuevas, Room 206

2nd: Ms. Jimenez, Room 406

2nd: Ms. Alquero, Room 407

2nd: Ms. Ward-Jenkins, Room 207

3rd: Ms. Campos, Room 405

3rd: Ms. Solari, Room 505

4th: Ms. Cadenas, Room 507

4th: Ms. Aguilar, Room 509

4th/5th: Mr. Baeza, Room 510

5th: Mr. Borg, Room 504

5th: Ms. Rojas, Room 506

6th: Ms. Dillon, Room 607

6th: Mr. Carrig, Room 706

6th: Mr. Wright, Room 703

7th: Mr. Case, Room 707

7th: Mr. Goldstein, Room 605

7th: Ms. Yolland, Room 606

8th: Mr. Sugar, Room 604

8th: Mr. Mullane, Room 603

8th: Mr. O'Neill, Room 704

RSP, Ms. Moore, Room 302

RSP, Ms. Crescenti, Room 408

Telephone of person filling out form/ Teléfono de persona completando la forma *

Relation of person to absent student/Relación al estudiante ausente: *

Mother/Mama

Father/Papa

Grandparent/Abuelo/a

Step-parent/Padrastro/a

Other:

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