Limited Excused Absence Form
A limited excused absence refers to a special group of absences that are limited in number and require approval by the Administration. Here are examples of limited excused absences (but not limited to): pre-approved vacations (with parents), religious trips/retreats, court appearances, state tournament attendance (as a fan), or family emergencies.

Limited excused absences should be made one week in advance (refer to the Student Handbook concerning limited excused absences) 5 DAYS MAXIMUM PER YEAR.

This form should be filled out by the parent/guardian.

Once the absence is approved, IT IS THE RESPONSIBILITY OF THE STUDENT TO FIND OUT THEIR ASSIGNMENTS AND HOMEWORK AND WHEN IT WAS DUE.

Consider this form APPROVED if you do not hear back from Mr. Hoffman.

Student Last Name: *
Your answer
Student First Name: *
Your answer
Date of first absence *
MM
/
DD
/
YYYY
Total number of school days absent *
Your answer
Please provide more details if any of the days will be partial attendance days.
Your answer
Reason for absence *
Your answer
Parent/Guardian Name: *
Your answer
Contact Phone Number: *
Your answer
Contact email
Please provide a contact email in case the district needs to contact you.
Your answer
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