PHS SY 19 - 20 Pre Arranged Absence Request
This form is intended to be a data collection point for students and parents requesting a pre-arranged absence from Pittsville High School. Please note that making the request does not ensure that the absence will be excused. State law requires that students are not excused for more than 10 school days a year.

Wisconsin school absence policy
sec. 118.16(4)(a). However, parents may excuse their child's absence in writing before the absence. A child may not be excused for more than 10 days in a school year under this provision, Wis. ... An excuse under this paragraph shall be in writing and shall state the time period for which it is valid not to exceed 30 days.

https://dpi.wi.gov/sites/default/files/imce/sspw/pdf/schlattendqa.pdf

Email address *
Please indicate the FIRST day of the absence: *
MM
/
DD
/
YYYY
Please indicate the LAST day of the absence: *
MM
/
DD
/
YYYY
Name of Student to be excused: (Last, First) *
Your answer
How many days from school? *
What is the reason for the absence? *
Your answer
1st Block Teacher? (if more than one, check both) *
Required
2nd Block Teacher? (if more than one, check both) *
Required
3rd Block Teacher? (if more than one, check both) *
Required
4th Block Teacher? (If more than one, check both) *
Required
Parent/Guardian contact email: (an email notification will be sent to the parent/guardian upon the completion of the review of the request.) *
Your answer
Parent/Guardian Name: *
Your answer
Parent /Guardian contact phone: *
Your answer
Please email Dr. Porter @ portecyn@pittsville.k12.wi.us upon completing this form to ensure the most prompt response.
Upon reviewing the request, Dr. Porter will notify the teachers. From Page 12 of the PHS Student Handbook: If the absence is excused, the teacher will assign make-up work for the missed period. The student will have a maximum of two (2)days to complete the assigned work. If the work is not made up within that time, or any extension the teacher may grant, the teacher will enter the work as “missing” in the gradebook. This may look like a “0” (zero) until the work is turned in. Upon receiving the work,the gradebook “0” (zero) will be changed to “incomplete” until the work can be graded. It is the student's responsibility to inquire about such work.
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Pittsville School District. Report Abuse