J.E. Jones Student Absence Report Form

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Please complete the form below to report a student absence. If your child is sick, please follow the guidelines for when to stay home listed on our district website. Regular absence procedures will apply and absences will count towards attendance records. You DO NOT need to call the school to report the absence, if you have reported it here.

Date *

YYYY

Child's First/Last Name *

Reason for Absence: *

Student is out due to Illness

Medical appointment

Jury duty

Observance of a religious holiday or retreat

Serving as an elections officer

Time with family member in active duty military

Personal Court appearance

Funeral services for family member

Other:

If you selected "other," please note the reason for the absence in the space below.

If your child is out ill, please mark all symptoms that apply. *If your child is not out ill, please mark "No, my child is not experiencing any of the above symptoms." *

Fever of 100.4 or greater/ chills

Cough

Shortness of breath or difficulty breating

Fatigue

Muscle or body aches

Headache

Sore throat

Congestion or runny nose

Nausea or vomiting

Diarrhea

No, my child is not experiencing any of the above symptoms.

Other:

Required

Date that these symptoms started: *

Guardian/Parent Name completing this form. *

Thank you. Please add any additional comments that you would like to communicate to the attendance office.

Submit

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