Middle and High School Attendance Request

Parents and Guardians, 

Please fill out the following information to provide the Mid-Pacific Middle and High School attendance office with your student's absence, tardy, or early release request. Information gathered will be kept confidential as part of the student record and will assist in recording the required information accurately. Please fill out one form per student. This form is to be filled out by PARENTS ONLY. 

Requests will be processed as soon as possible. As we work to support students and other Middle and High School operations, please allow a minimum of 2 hours for processing.  

** TRAVEL: If your request pertains to future travel plans, please email the respective grade-level dean directly for approval.  

**AFTER-SCHOOL CLASSES: If your attendance request will only affect the time your student is in an after-school class, please email globalx@midpac.edu for assistance. 

Please provide the parent or guardian's email address in the space below.

Sign in to Google to save your progress. Learn more
Email *
Attendance notification for: 
Clear selection
Parent / Guardian: First and Last Name *
Parent / Guardian: Telephone Number *
Student: First Name *
Student: Last Name *
Grade *
Absent, Tardy or Early Release *
First Day of Absence, Tardy or Early Release *
MM
/
DD
/
YYYY
Last Consecutive Day of Absence, Tardy or Early Release
MM
/
DD
/
YYYY
Time Student will Arrive Tardy or Needs to be Released
Time
:
If an early release was requested and the student will return to campus, please provide an estimated return time.  
Time
:
Reason *
Please provide additional information regarding the reason listed above.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Mid-Pacific Institute. Report Abuse
Google Forms