Request for Independent Study

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Independent study is for 5 or more days only and for no more than 15 cumulative days in the school year. Requests for an Independent Study must be made at least 10 school days prior to the expected absence to allow time for teachers and staff to process the request. Once this form is submitted, someone will get back to you within 3 days. Please note: submission of this form does not guarantee approval of your Independent Study.

Email *

Today's Date *

Student's First and Last Name *

Student's Grade *

Student Cohort *

Parent Email *

Parent's First and Last Name *

Parent Daytime Phone Number *

First Day of Independent Study *

YYYY

Last Day of Independent Study *

YYYY

Reason For Independent Study *

Parent "Signature" *

By checking this box you understand that a copy of ALL school work needs to be turned into the Attendance Desk as well as directly to each teacher, in order to be considered as Independent Study (IS) completed.

I understand

A copy of your responses will be emailed to the address you provided.

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