Central School: Reporting a Student Absence

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Please report student absences with this form before 9:00 AM.

LEGAL NOTICE: This form is to be filled out and submitted only by the student's parent or legal guardian. In the event that a person other than the student's parent or legal guardian fills out and submits this form, D35 reserves the right to take any legal action for fraudulent submission and/or take disciplinary action against any D35 student(s) involved. We reserve the right to call home and verify the absence as needed.

PLEASE NOTE:
* Late arriving students MUST check in at the main office.

Email *

Parent/Guardian Last Name *

Parent/Guardian First Name *

Student Last Name *

Student First Name *

Grade/Advisor *

Starting Date of Absence: *

YYYY

Anticipated Returning to School on: *

YYYY

Reason for Absence *

Illness

Family Emergency

Vacation

Observance of a Religious Holiday

Death in the Immediate Family

Doctor (Including Dentist & Orthodontist)

Appointment (other than medical/dental)

Other:

If you checked ILLNESS for the absence reason, please share the symptoms your child is experiencing. Check all that apply.

Fever

Cough

Sore throat

Fatigue from unknown cause

Muscle or body aches from unknown cause

New onset of moderate to severe headache

New loss of taste or smell

Vomiting

Diarrhea

Other (list symptoms - not "cold"):

Other:

Estimated time leaving school

Estimated time arriving at school

If your student is leaving with someone other than a parent/guardian or emergency contact listed in Skyward, enter the name of the adult picking up here:

A copy of your responses will be emailed to the address you provided.

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