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CHMS Attendance Form
Please report your student's absence here. Please complete one form for each child you are reporting absent.
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* Indicates required question
Email
*
Your email
Preferred Language - Idioma preferido
English
Espanol
Other
Clear selection
Student's Last Name/
Apellido del estudiante
*
Your answer
Student's First Name/
Nombre del estudiante
*
Your answer
Grade
6
7
8
Clear selection
Date of Absence (month/date/year). If more than one day, list all dates below (month/date/year to month/date/year).
Fecha de Ausencia (mes/fecha/año). Si es más de un día, enumere todas las fechas a continuación (mes/fecha/año a mes/fecha/año).
*
Your answer
Reason for Absence
*
Illness/ Enfermedad
Injury/Lesión
Doctor Appointment/Cita con el Médico
Dental Appointment/Cita Dental
Orthodontist Appointment/Cita con el Ortodoncista
Speech Appointment/Discurso Cita
Therapy Appointment/Cita de Terapia
Hospital
Funeral for immediate family/Funeral para Familia Inmediata
Religious Holiday/Vacaciones Religiosas
Vacation - Out of Town/Vacaciones - Fuera de la Ciudad
Personal Reason/Razón Personal
Mental Health/Salud Mental
Describe illness or symptoms here
Describa la enfermedad o los síntomas aquí
Your answer
Absent All Day/
Ausente todo el día
*
Yes
No
If partial day, what time frame?
Si es día parcial, ¿en qué período de tiempo?
*
Your answer
If the student is leaving early, please indicate what time you would like your student to be ready.
Si el estudiante se va temprano, indique a qué hora le gustaría que su estudiante esté listo.
*
Your answer
Parent/ Guardian Name
Nombre del Padre de Familia / Guardian
*
Your answer
Please list any additional information here.
Por favor enumere cualquier información adicional aquí.
Your answer
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