If you know your child is going to be out for an extended amount of time (3 consecutive days or more) you
must fill out a leave of absence form from the office.

The following are excused absences:

• Personal illness that exceeds three consecutive days- with a doctor’s note
• Death of a relative (provide documentation)
• Observance of religious holiday
• Military block leave- up to 5 school days with a copy of military orders
• Doctor, dental and therapy appointments with proper documentation (If possible,
please schedule such appointments after school hours)
• Emergency situations- such cases may be approved by administration on an
individualized basis

The following are unexcused absences:

• Personal illness that exceeds three consecutive days without a doctor’s note –
While we understand illness happens; a parent phone call or note will not
constitute an excused absence.
• Military block leave without orders
• Family events- vacations, birthdays, family visits, other family members’
appointments, etc.

Student Name (First and Last) *
Date of Absence *
Reason for Absence *
Illness Symptoms (if applicable) *
Any additional information you would like us to know.
Parent/Guardian Name *
Parent/Guardian Contact Phone Number *
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