Absence Request Form
PLEASE DO NOT USE THIS FORM FOR THE APPROVED REASONS BELOW OR EARLY DISMISSALS.

In accordance with Boston Public Schools Policy, the following are reasons for absences to be excused:

- An illness or injury that prevents the student from attending school. The illness or injury must be verified by a health care provider, school nurse, or parent.
- A death in the immediate family (parent, sibling, grandparent, aunt, uncle, cousin) or other significant personal or family crisis
- Court appearances (must bring a note from court)
- Medical or psychological tests during the school day. The parent must show evidence (such as a note from the health center) that the tests could not be scheduled after school.
- Visits to special education schools in some cases for students with disabilities

Absences outside of these reasons are not excused without application and approval. A maximum of 5 days per BLS career are approved through this process.


The above approved absence reasons should be submitted to your student's homeroom teacher upon return.
Dismissals should be submitted to the guidance office in accordance with the handbook guidelines.

Parent / Guardian email address *
THIS EMAIL ADDRESS MUST MATCH THE PARENT/GUARDIAN EMAIL ON FILE IN SIS
Your answer
Student Last Name *
Your answer
Student First Name *
Your answer
Student ID Number *
Your answer
Graduation Year *
Date of absence request *
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Additional date of absence (if applicable)
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Additional date of absence (if applicable)
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Additional date of absence (if applicable)
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Additional date of absence (if applicable)
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YYYY
Reason for request - Please remember that approvals are reserved for family commitments that cannot be scheduled outside of regular school days. *
Your answer
Please email any supporting documentation - using the subject "Absence Request" - to Joel Giacobozzi at jgiacobozzi@bostonpublicschools.org
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