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Burbank: Report an absence
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* Indicates required question
Date of absence / Fecha de la ausencia *
*
MM
/
DD
/
YYYY
Student's Last Name / Apellido del Estudiante * *
*
Your answer
Student's First Name / Nombre del Estudiante * *
*
Your answer
Name of person reporting absence / Nombre de la persona reportando la ausencia * *
*
Your answer
Relation to Student / Relación al Estudiante *Must be a guardian or listed in emergency contacts / Debe ser guardián o enumerada en contactos de emergencia *
*
Mother or Father / Madre o Padre
Legal Guardian / Guardián Legal
Grandparent / Abuelo(a)
Aunt or Uncle / Tía o Tío
Reason for the absence / La razón por la ausencia * *
*
Illness or injury (see next question) / Enfermedad o herida (ver la siguiente pregunta)
Medical appointment / Cita medical
Family emergency / Emergencia familiar
Vacation or personal reasons / Vacaciones o razones personales
Religious observance or ethnic holiday / Observancia religiosa o festividad étnica
Bereavement / Pérdida
Other/otra razon:
If illness or injury is the reason for absence, please share the type of illness, symptoms, or injury here: / Si una enfermedad es el motivo de la ausencia, comparta el tipo de enfermedad, síntomas, o herida aquí:
Your answer
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