2023-2024 Absence Form

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Please fill out the below information regarding your student's absence.

Absences for three days or more will require a doctor's note to be excused.

When your student returns to school they will be given make up work from their teacher(s). Please note that work will only be sent home for students that will be absent for three or more days.

Email *

Student Name *

Student Grade *

Date(s) of Absence *

Reason for Excused Absence *

Illness or Injury: When the absence results from illness or injury which prevents the student from being physically able to attend school.

Medical or Dental Appointments: When the absence results from a medical or dental appointment of a student.

Educational Opportunity: When it is demonstrated that the purpose of the absence is to take advantage of a valid education opportunity, such as travel. Approval for such an absence must be granted prior to the absence. This would include, but is not limited to, a student serving as a legislative page or a governor's page.Please provide details of the Educational Opportunity in the Additional Information Section below:

Quarantine: ordered by local health officer or by the State Board of Health

Death in the Immediate Family: When the absence results from the death of a member of the immediate family of the student. For the purpose of this regulation, the immediate family of a student includes, but is not necessarily limited to, grandparents, parents, brothers, and sisters.

Court or Administrative Proceedings: When the absence results from the attendance of a student at the proceedings of a court or an administrative tribunal if the student is a party to the action or under subpoena as a witness. The Local Board of Education can be considered an administrative tribunal.

Religious Observance: School principals are required to authorize a minimum of two excused absences each academic year for religious observances required by faith of a student or a student's parents. The student shall be given the opportunity to make up any tests or other work missed due to this excused absence. (S.L. 2010-112)

Other:

Parent Name reporting the Absence *

Additional Information (if necessary)

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