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Reason For Absence Note
Whenever your child is absent, please complete this form or email a note to:
Esmeralda Marrero (
emmarrero@cps.edu
) for the branch
Odillia Garcia (
ogarcia@cps.edu
) for the main building
Rida Hajduk (
rshwaiki@cps.edu
) for the early childhood center
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* Indicates required question
Student's Name / Nombre Del Estudiante
*
Your answer
Student's Room and Grade Level / Salon del Estudiante
*
Your answer
Date(s) of Absence/Fecha(s) De La Ausencias
*
Your answer
Indicate Below the Valid Cause for the Student's Absence(s)/Indique debajo la razòn válida para la ausencia:
*
Student's Illness/Enfermedad Del Estudiante
Observation of a religious holiday / Observación Religiosa
Death in the Immediate Family/Muerte En La Familia Inmediata
Family Emergency (Explain Below)/Emergencia Familiar (Explique Abajo)
Circumstances which cause reasonable concern to you for your child's safety or health (Explain Below) /
Other situations beyond the control of the student (Explain Below)/Otras Situaciones Fuera De Control Del Estudiante (Explique Abajo)
Explanation for your response above: / Explicación de su respuesta anterior:
*
Your answer
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