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Faculty and Student Absentee Form
Please fill out one form per absentee by 8:15 a.m.
***Faculty, please note, this form is in addition to the faculty absent form needed for coverage.
Thank you,
Nurse Navi and Nurse Rachel
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* Indicates required question
Email
*
Your email
Parent/Faculty Cell Phone number
*
Your answer
First Name of Absentee
*
Your answer
Last Name of Absentee
*
Your answer
Grade
*
Choose
Ganon
Gan
1
2
3
4
5
6
7
8
Faculty
Section
*
Choose
A
B
C
D
E
G
Middle School
Faculty
Bus/Carpool
*
Carpool
1
2
3
4
5
6
7
8
9
10
12
13
14
15
Faculty
Other:
Reasons for absence. Please check all of the symptoms that apply below.
*
Fever
Chills
Body Shaking
Diarrhea
Cough
Headache
Fatigue
Nausea/Vomiting
Shortness of breath
Sore throat
Runny nose/Congestion
Muscle Pain
Loss of taste sensation
Loss of smell sensation
Other:
Required
Please list any siblings, include their grade/class and the school they attend.
*
Your answer
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