Report an Absence / Reportar una Ausencia

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Please use this form to report to provide a reason for your student's absence. / Utilice este formulario para informarnos del la razón por la ausencia de su estudiante.

Date *

Please enter as mm/dd/yyyy, or enter multiple dates / Ingrese mm/dd/aaaa o ingrese varias fechas

Student's Last Name / Apellido del Estudiante *

Student's First Name / Nombre del Estudiante *

Name of person reporting absence / Nombre de la persona reportando la ausencia *

Phone number of person reporting / Numero de telephono de la personal reportando *

Please use the format 123-456-7890 / Por favor utilice el formato 123-456-7890

Relation to Student / Relación al Estudiante *

Must be a guardian or listed in emergency contacts / Debe ser guardián o enumerada en contactos de emergencia

Parent / Padre

Legal Guardian / Guardián Legal

Grandparent / Abuelo(a)

Aunt or Uncle / Tía o Tío

Other:

Reason for the absence / La razón por la ausencia *

Illness or injury (see next question) / Enfermedad o herida (ver la siguiente pregunta)

Medical appointment / Cita medical

Dental appointment / Cita dental

Orthodontist appointment / Cita ortodontista

Family emergency / Emergencia familiar

Vacation or personal reasons (NOT illness, unexcused) / Vacaciones o razones personales (NO enfermedad, inexcusada)

Religious observance or ethnic holiday / Observancia religiosa o festividad étnica

Bereavement (i.e. Funeral)/ Pérdida (e.g. Funeral)

Other:

If illness or injury is the reason for absence, please share the type of illness, symptoms, or injury here: / Si una enfermedad es el motivo de la ausencia, comparta el tipo de enfermedad, síntomas, o herida aquí:

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