Mifflin Student Absence Form 2026-2027
Please fill out this form if your student is absent. All absences will be considered unexcused unless either (1) this form is completed or (2) a physical note is returned to the student's homeroom teacher.

This form should be completed for only one student at a time.
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Email *
Parent/ Guardian Name (Your Name) *
Parent/ Guardian Phone Number *
I certify that I am the legal parent/guardian/caretaker for this student.
 *
Student Name (First and Last) *
Student Grade Level *
Homeroom Teacher
How many days was the student consecutively absent?
 *
First Date of Absence *
MM
/
DD
/
YYYY
Last Date of Absence (will be same as the First Date of Absence if the student was absent for only one day) *
MM
/
DD
/
YYYY
Reason for Absence *
A copy of your responses will be emailed to the address you provided.
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