Planned Absence Form
A Planned Absence must meet the following criteria:

1. Students must be current in their school work, with no less than a 70 grade average
2. Must not have excessive absences or excessive discipline issues
3. Planned Absence forms must be turned in 5 days prior to the planned absence
4. School work is due upon return

Approval of a planned absence is not necessarily an excused absence. Absences will be coded excused/unexcused based on the nature of the absence. If the absence is academic, an enrichment activity, or based on need (family emergency) there is a greater likelihood of it being excused.

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Email *
Student's Name and Grade:
Date Leaving:
MM
/
DD
/
YYYY
Date Returning:
MM
/
DD
/
YYYY
Reason for absence:
Parent Name and Date:
Secondary Students: Please list your teachers by class period:
A copy of your responses will be emailed to the address you provided.
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