Jones Blackhurst Student Absence Note
Please complete this form when your student(s) is or will be absent from school. Please complete a separate form for each student. If you have a medical note, please email it to:
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Name of Student:
Teacher / Grade:
Date(s) of Absence(s):
Reason of Absence:
Dr. Appointment (MDP with Doctor Note)
Family Emergency (CIR)
Death in the Family (CIR)
Going Out of Town (CIR)
Pre-Arranged (CIR) *NOTE - Per CCSD, the maximum number of pre-arranged (CIR) absences is 10 per school year.
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This form was created inside of Clark County School District.