Family Leave Request Form
The following guidelines must be followed by students on family leave. Submitting this form means that you agree to the following:
1. See teacher(s) in advance of departure concerning homework and class work
2. Homework, class work, and test MUST be completed and/or turned in the day your student returns to school
3. Approved family leave days are considered excused absences, but are counted in the absence policy
Student(s) Name and Grade
Family Leave Date(s) Requested
Reason for the Request
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