EBS Elementary Absence Notification
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* Required
Student First Name:
*
Your answer
Student Last Name:
*
Your answer
Teacher / Room Number
*
Your answer
Date(s) of Absence - Beginning
*
MM
/
DD
/
YYYY
Date(s) of Absence - Ending
MM
/
DD
/
YYYY
Reason for Absence
*
Examples: Illness (must specify symptoms, fever, cough, stomach ache, etc.), out of town, medical appointment, family emergency, etc.
Your answer
Parent First Name
*
Your answer
Parent Last Name
*
Your answer
Relationship to student (mother, father, guardian)
*
Your answer
Telephone Number
*
Your answer
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