DFES Student Absence Excuse Form
Parents, you may now use this electronic form to submit an excuse for your child's absence from school. Please complete each section below to ensure the excuse is accepted. If you have any questions, please contact Sharon Clemens, Registrar/ Attendance Clerk, at 803-476-3900. Thank you for helping us maintain our commitment to making our students feel safe, valued and loved. Julius Scott, Principal, Dutch Fork Elementary School, Academy of Environmental Sciences
Student First Name
Student Last Name
Parent First Name
Parent Last Name
Abu Abdo, D.
Date of your child's absence from school:
Reason for your child's absence from school:
Lawful Absence- Student illness
Lawful Absence-Death in family
Lawful Absence- Serious illness in immediate family
Lawful Absence Medical or legal appointment (Please submit documentation)
Lawful Absence- Preapproved school activity
Lawful Absence- Excused by School Nurse
Unlawful Absence- Absent without acceptable cause
Principal Preapproval Required - Reason for your child's absence from school:
Lawful Absence- Religious Holiday (Must be preapproved by Principal)
Lawful Absence- Parent note (Preapproved by Principal)
Unlawful Absence- Parent note (including trips or vacations)
If you have a medical excuse or bereavement notice, please upload the document below.
Sign to Complete
Please type your name in the space below as your electronic signature. I certify that the electronic signature below is authentic, that the absence request is mine alone and has not been shared with another. I further understand that misrepresentation of the absence request and/or the below electronic signature will automatically nullify this request and any absence incurred will be marked as unexcused.
Parent or Guardian Electronic Signature
Office Use Only
Page 1 of 1
Never submit passwords through Google Forms.
This form was created inside of Lexington/Richland School Dist. 5. -
Terms of Service