Report an Absence

Please complete all the the information below. If Student Services has any questions, a staff member will contact the student's parent/guardian for clarification. Thank you.

Student Name
Student Number
Student's Grade

Student's Grade K 1 2 3 4 5
Parent/Guardian Name
Parent/Guardian Contact Phone Number
Parent/Guardian Email (If you would like a confirmation emailed to you)
Date(s) of absence(s):
I am reporting my student for being:

I am reporting my student for being: Absence Tardy
Reason for Absence(s) or Tardiness:

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:
Please upload Dr.'s note here.

Attach Files
Additional information