JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
ADL Online Absence Form
You can also reach the main office at: 802-857-7005. When finished, hit your browser's back button, to return to ADL's website.
Please call the nurse at 857-7027 if you have questions. The nurse may also call you if additional information is needed.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Your full name (First Last)
*
Your answer
Phone where can you be reached?
*
Your answer
Student First Name
*
Your answer
Student Last Name
*
Your answer
Grade
*
Choose
Grade 6
Grade 7
Grade 8
Date of Absence
*
MM
/
DD
/
YYYY
Reason for Absence
*
Illness
Medical Appointment
Tardy/Late Arrival
Other:
Required
Comments
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Essex Westford School District.
Report Abuse
Forms