Daily Attendance Form

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During S@H instruction, parents/guardians of students in our secondary schools (the High School, Jefferson Middle, and/or Mellon Middle) should use this form to submit an excuse if their child is unable to participate in instruction throughout the course of the day. If an excuse is not submitted using this form, students will be marked present and expected to access their learning online and complete assigned tasks for the day.

Student's Last Name *

Student's First Name *

Student ID (Lunch number)

Grade *

Building *

Homeroom Teacher's Name *

Date of Absence *

YYYY

Attendance *

Absent for the Full Day

Absent for the Morning (AM)

Absent for the Afternoon (PM)

Reason for absence (per Mt. Lebanon School Board policy JED- Student Absences and Excuses) *

Personal Illness

Medical or dental appointment

Quarantine

Death in the immediate family

Traditionally-recognized religious holiday

Approved 4H/FFA/FHA participation in authorized Pennsylvania agricultural fairs

Required court appearances or attendance

Other:

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