Coolidge Attendance Form
All absences must be reported no later than 24 hours after the absence in order to be excused.
Student Last Name
Student First Name
Teacher Last Name
In this box, please type your first and last name.
Please check yes below to acknowledge the following statement: "By checking the signature box, I certify that I am the legal guardian of this child and all of the information provided to Livonia Pubic Schools School District is accurate"
Reason for Absence
Please select the reason for your child's absence from the list below.
Is the reason for absence due to a communicable disease?
If not, select "No." Otherwise, please select the disease your child has been diagnosed with. This question is required to comply with county standards.
Conjunctivitis (Pink Eye)
Pertussis (Whooping Cough)
Date of Absence
If absence is multiple dates, please select the first absence date.
If this is a multiple day absence, please enter the last date the student will be absent.
If absence is multiple dates, please select the last absence date. If a one day absence, please leave blank
Is this a full day absence?
Never submit passwords through Google Forms.
This form was created inside of Livonia Public Schools.