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Grant Attendance Form
Please Note: All fields marked with a red Asterisk are required fields.
To be completed by parent/legal guardian only.
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* Indicates required question
Student First Name
*
Your answer
Student Last Name
*
Your answer
Grade
*
Choose
K
1st
2nd
3rd
4th
Teacher Last Name
Your answer
Your name
*
In this box, please type your first and last name.
Your answer
Acknowledgement
*
Please check yes below to acknowledge the following statement: "By checking the signature box, I certify that I am the legal guardian of this child and all of the information provided to Livonia Public Schools School District is accurate"
Yes
Required
Reason for Absence
*
Please select the reason for your child's absence from the list below.
Choose
Sick
Appointment
Family Business
Bereavement
Travel
Religious Holiday
Other
Is the reason for absence due to a communicable disease?
*
If not, select "No." Otherwise, please select the disease your child has been diagnosed with. This question is required to comply with county standards.
Choose
No
Covid 19
Chicken Pox
Conjunctivitis (Pink Eye)
Influenza
Meningitis
Mononucleosis
Mumps
Strep Throat
Shigella
Head Lice
Measles
Fifth Disease
Hand/Foot/Mouth Disease
Pertussis (Whooping Cough)
Rubella
Date of Absence
*
If absence is multiple dates, please select the first absence date.
MM
/
DD
/
YYYY
Multiple Day Absence Ends
If absence is multiple dates, please select the last absence date.
MM
/
DD
/
YYYY
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