2019-2020 Absence Form
Please complete this form for each of your children each time they are absent
Student's name (First, Last)
Date(s) of Absence(s) (MM/DD/YYYYY)
Please enter start & end date if the absence is for multiple consecutive days.( Ex: 00/00/0000-00/00/0000)
Reason for Absence
Excused- Injury or Illness (Documentation may be required)
Excused- Medical or Dental Appointment (Please provide Drs note to Office)
Excused-Director Approved Educational Leave
Excused-Court or Administrative Proceedings(Documentation may be required)
Excused- Death in the Family
Parent Name (E Signature)
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This form was created inside of FernLeaf Community Charter School.