Student Absence Reporting

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Please fill out form completely. An office staff member may contact you to verify information.

Email *

Student's full name
*

Grade Level
*

Teacher's Name

Date(s) of absence

*Please use mm/dd/yy format, not day of the week.

Reason for absence.
*

Illness

COVID

Doctor/Dentist appointment (Must be studen'ts appointment. Please send note with child when they return to school.)

Funeral

Court appointment requiring student's presence.

Family emergency

Vacation/Out of town

Personal reason

Other:

Required

Full name of person reporting the absence.
*

Parent phone number
*

Relationship to student
*

Parent

Guardian

Grandparent

Other:

Required

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