Report an Absence

Student's Name

Grade

Teacher

Parent/Guardian Name

Parent/Guardian Contact Phone Number

Parent/Guardian Email

Date of Absence(s)

I am reporting my student for being

Tardy Absence

Please upload Doctor's note or other document

Reason for Absence(s) or Tardiness

Illness of the student Major illness in the immediate family Death in the immediate family Religious holiday Religious instruction, conference, institutes, etc. Court order/subpoena Other (please explain below) - may be excused pending administrative approval:

Additional Information

Report an Absence

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