Dana MS Independent Study Contract Form 

For details about our full independent study policy, please visit: https://docs.google.com/document/d/1Z7xzg3nfl-a7hFWQfaauPW2R_ifqa7VjvHW0-QrsNfw/edit?tab=t.0

Independent study is an alternative for students to earn attendance credit for any reasonable excuse, including illness. 

Student attendance is essential to student success and learning during the school year. We recognize that families often have planned (e.g., vacations, holidays, sports events, etc.) or unplanned absences (e.g., illness, bereavement, etc.), and we want to support our students with their school work while providing them with the opportunities to take part in the planned or unplanned activities that occur. 

Students may utilize the independent study option up to 15 school days a school year. No student will be approved for independent study that exceeds 15 days collectively during the school year. Students can complete an independent study (IS) if their absence (planned or unplanned) is three days or more. 

  • At the Principal’s discretion, one and two-day IS contracts can be approved for limited reasons. Please reach out to the Principal after completing your IS form. 

  1. Step 1: Parents/guardians and students should complete the independent study contract form to initiate the IS. This form should be completed as soon as you know of the IS. You will receive an automated email copy of the independent study contract. 

    1. Your contract will be automatically denied if you exceed the 15-day limit.

  2. Step 2: From there, the parents/guardians and student should review this document to find their directions from their teacher regarding next steps. If you have a question regarding the directions, reach out directly to the teacher. 

  3. Step 3: Complete the work 

  4. Step 4: Turn in the work and “close” the independent study

  • When students return to school, they should complete their work and submit it to their teachers within one week of return from the IS. 

  • At the end of the grading period, school staff will notify the family if the completed work was deemed to earn credit for IS.

    • At which point, the attendance code will be changed from G to P, Q, or other appropriate attendance code per district policy. This shows that the student earned attendance credit. 

    • The attendance clerk will email the family to let them know the results. 

    • At the grading period, all outstanding IS attendance codes at G will be turned to U for unexcused.

For more information, please the grade level clerk assigned to support you:

The school principal or their designee has the final authority to grant or deny independent study contracts. 



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Email *
Email address of parent/guardian completing form [this must match contact in powerschool] *
Parent/Guardian Name completing form  *
Parent/Guardian Phone number *
Student Last Name *
Student First Name *
Student ID Number *
Date of Birth  *
MM
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DD
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Age *
Address *
City and Zip *
School Enrolled *
Grade *
Independent Study Reason  *
Is this contract being requested due to COVID-19 illness and/or quarantine? *
Has your child completed an independent study previously this year? [please note that students may only complete up to 15 total days a year of independent study) *
Program Placement (choose one) *
Beginning Date  *
MM
/
DD
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YYYY
Ending Date  *
MM
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DD
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YYYY
Number of School Days  *
Return to School Date  *
MM
/
DD
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YYYY
Student's English Language Arts Teacher/ Lit Adv *
Student's Math Teacher *
Student's Social Studies Teacher  *
Student's Elective Teacher  *
Student's Science Teacher  *
Student's PE Teacher  *
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