Dolly Ridge Elementary Principal Approved Absence
Complete this request form if your child must be absent for reasons other than illness, hospitalization, emergency, death in the immediate family, court subpoena, religious holidays or absences approved by the principal.  Approval will be based on, but not limited to, the following conditions:

a. requested number of days absent plus current cumulative absences, must not exceed ten (10) days.  Approval is subject to change should the student accumulate absences in excess based on VHCS Attendance Policy;

b. requested dates of absence do not occur during state/district testing dates;

c. parent and student agree to complete all missed assignments within five (5) school days of returning to school;

d. the Pre-Approved Absence Form must be submitted at least three (3) school days prior to absence.

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Email *
1. Student Legal Name: *
2. Current Grade: *
3. Will the student be absent a full day or partial day? *
4. Date of Absence (First Day): *
DATE:  Please enter the FULL YEAR (i.e. 2021)
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5. Date of Absence (Last Day): *
DATE:  Please enter the FULL YEAR (i.e. 2021)
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6. Total Number of Days Absent: *
7. Reason for requesting a Pre-Approved absence? *
8. Do you have another child(ren) in the district for whom you will be requesting a Pre-Approved absence? *
9. If yes, select the school(s) your other child(ren) is attending.  (NOTE: Each student request must be submitted separately, by school.)
Parent/Guardian Acknowledgement:
My signature and submission of this form verifies, I am the legal parent or guardian of the above named student and I understand the approval of my request is not guaranteed under the conditions outlined in this form.
Name of Parent/Guardian submitting request: *
Today's Date *
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