Request for Absence

Student safety our a priority.

Please fill this form out three weeks prior to an absence. Communication in a timely manner is the key to resolving any conflicts that may arise through understanding and comprimise. If there is an emergency please contact Mr. Thomann via email (jonathan.thomann@berkleyschools.org) at the next convenient opportunity.
Email address *
Student First Name *
Your answer
Student Last Name *
Your answer
Parent/Guardian Name *
Your answer
Parent/Guardian Name *
Your answer
Emergency Phone Number *
Your answer
Requested Absence Date *
If multiple days a separate request must be filled out. This includes late arrivals and early dismissals.
MM
/
DD
/
YYYY
Time
:
Reason for Request for Absence *
Your answer
A copy of your responses will be emailed to the address you provided.
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