Niji-Iro Attendance Form
Please Note: All fields marked with a red Asterisk are required fields.

To be completed by parent/legal guardian only.

Student First Name *
Your answer
Student Last Name *
Your answer
Grade *
Teacher Last Name
Your answer
Your name *
In this box, please type your first and last name.
Your answer
Acknowledgement *
Please check yes below to acknowledge the following statement: "By checking the signature box, I certify that I am the legal guardian of this child and all of the information provided to Livonia Pubic Schools School District is accurate"
Required
Reason for Absence *
Please select the reason for your child's absence from the list below.
Is the reason for absence due to a communicable disease? *
If not, select "No." Otherwise, please select the disease your child has been diagnosed with. This question is required to comply with county standards.
Date of Absence *
If absence is multiple dates, please select the first absence date.
MM
/
DD
/
YYYY
Multiple Day Absence Ends
If absence is multiple dates, please select the last absence date.
MM
/
DD
/
YYYY
Submit
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