Planned Absence Form

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Email *

Student Name (first and last) *

Grade *

Advisor(s) *

Date(s) you will be absent. You must format them as MONTH (written out) then DAY (example: September 22 or October 1, 4, 5) *

List periods you will miss (example: 2, 4) OR write "all day" *

Reason for absence *

Appt (medical, dental, counselor, etc.)

Sports/athletics (Lakeside or club team)

Religious holiday/observance

College visit (seniors only)

Funeral, memorial service, etc.

Family trip/vacation/reunion/wedding

Other (describe below)

SHORT written explanation of absence (example: Volleyball Tournament in Spokane or Medical Appt) *

Is this planned absence longer than 3 days? *

Note: if you checked yes, you're planned absence form is not complete until you have heard from an US Assistant Director

Yes

Has your family filled out an Absence Request or contacted Mr. Kempf? (more info on how your family can report here) *

Yes

I will ask them to

Required

When you hit "submit," this form will automatically send you a copy of your responses. Your planned absence form is NOT CONSIDERED COMPLETE until you FORWARD those responses to each teacher whose class you will be missing, your advisor(s), and our attendance keeper Taylor Kempf! *

I promise to forward my responses to all of my teachers, advisors, and Mr. Kempf!

I also promise to submit my response by 3:00PM the day prior to my absence!

I will also check-in with my teachers in-person before the day that I miss.

Required

Final Instructions

Dear Teachers,

Please see my message below....

A copy of your responses will be emailed to the address you provided.

Submit

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