Excused Absence & Tardy Request 
Please remember that you have 3 days to request an excuse for your child's absence.  If it sent in after the 3 days it will not be excused. As of 9/1/23: The email that needs to be used can not be a students email, it must be the email used on the Emergency Card.

Sign in to Google to save your progress. Learn more
Email *
Student Name (First Middle Last) *
Student ID *
Date of Absence *
MM
/
DD
/
YYYY
If more than one day, enter subsequent days here:
Periods Missed (check all that apply) *
Required
Reason   (please email any doctor notes or documentation of absence to  jgilmore@pivotcharterschool.com) *
Parent Cell Phone Number: *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Pivot Charter School. Report Abuse