Grant High School Absence Clearance Form

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Dear Parents or Guardians:

This form will assist in proper attendance accounting as required by the State Superintendent of Public Instruction in the application of State Law and State Board of Education rules for apportionment of State funds to school districts. Your cooperation in completing this form and submitting it to the school upon his/her return to classes will be appreciated.

Per LAUSD policy, all absences must be cleared within 10 school days with satisfactory explanation.

Attendance is critical for learning and academic success. It is the expectation of Ulysses S. Grant High School and LAUSD that students have no more than SEVEN ABSENCES for the entire school year.

Medical appointments should be scheduled after school hours or during school breaks.

Email *

STUDENT'S FIRST NAME *

STUDENT'S LAST NAME *

Student's Date of Birth *

YYYY

Grade Level *

Date(s) student was absent *

Student was absent period(s) *

All day

Period 1

Period 2

Period 3

Period 4

Required

Reason for Absence *

Medical / dental / eye appointment (Doctor’s office verification required)

Illness (sick) of student (Absences exceeding 3 days require a doctor’s note)

Injury of student

Funeral of an immediate family member (Please complete REF 5464.10)

Religious holiday (Please complete REF 5464.10)

Court appearance (Please complete REF 5464.10)

Family vacation / emergency (UNEXCUSED)

Entertainment business related - Verification required before the absence

College tour (12th grade only) - Verification required

Other:

Parent/Guardian’s First Name *

Parent/Guardian’s Last Name *

Send me a copy of my responses.

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