Amount of Time (*Office Personnel will calculate time to denote late/early released compared to half-day) * *
Reason for Absence *
I understand that after ten (10) total days of absence for any reason, medical documentation will be required for any absence to be considered excused. *
I affirm I am the Parent or Legal Guardian of the above child and attest that I am completing this form as such. (Please type your full legal name as your signature.) *
Your answer
If at any time, it is declared that the parent/legal guardian of the said child has not completed this form, official truancy, forgery, and/or fraud may be filed with the appropriate County Agencies. *
A copy of your responses will be emailed to the address you provided.