Vacation / Planned Absence Request
Please complete this form if your student(s) will be missing any classes. We will have work ready
in advance for you to take along on vacation. Please return all completed/graded homework at the next attendance.

** When Possible, please provide at least 1 week advance notice.
Sign in to Google to save your progress. Learn more
Email *
Student(s) Name *
Parent(s) Name *
Phone Number *
Last class before Vacation *
MM
/
DD
/
YYYY
Student will resume class *
MM
/
DD
/
YYYY
Please let us know any workload adjustments during vacation / planned absence *
Let us know if you have any special requests, questions or comments.
FOR OFFICE USE: Processed
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of iKumon.com. Report Abuse
Google Forms