W.R. Odell Primary School – Extended Leave Form 2025–2026
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Email *
Student First and Last Name:
 *
Parent/Guardian Name *
Teacher Name: *
Last Date in Class: *
MM
/
DD
/
YYYY
Return Date: *
MM
/
DD
/
YYYY
Total number of school days being missed: *
Where is your student going? *
Reason for leave: *
Instruction: Please read each statement and check the box to indicate your acknowledgment. All items must be acknowledged.
My student's absences are unexcused on extended leave *
Required
My student must return all library books before leaving *
Required
Upon returning, parents must provide current residency proof (deed or lease & current utility) *
Required
Teachers are not required to prepare assignments/work for my student *
Required
I will receive Parent Square alerts & attendance letters regarding my child’s unexcused absences *
Required
Extended leave differs from Educational Opportunity, and these forms are not always combined *
Required
My student may miss literacy/math district assessments if they are absent during the testing window *
Required
I understand that absences & lack of progress toward end-of-year mastery due to absences will factor into grade promotion/retention decisions *
Required
My student may lose their current bus assignment due to absences *
Required
Bus Number: *
20 absences are equivalent to a month of instructional time. 20+ absences are considered excessive *
Required
If my child is absent the last 10 days of school (May 8–May 21), they will be automatically withdrawn from Odell Primary *
Please ensure all required fields are completed. This form will be automatically submitted to the Data Manager at W.R. Odell Primary
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