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Absentee Request Form
Student First Name
(Required)
Student Last Name
(Required)
Grade
(Required)
9
10
11
12
Absentee Request
(Required)
My Child Will be Absent
My Child Needs an Early Dismissal
My Child Will be Arriving Late
Reason for Absence
Date(s) of Absence
(Required)
MM slash DD slash YYYY
Reason for Absence
(Required)
Illness
Covid Exposure
Family Vacation
Other
Notes
Reason For Early Dismissal
My Child Needs an Early Dismissal At:
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Reason for Early Dismissal
(Required)
Illness
Travel
Appointment
Other
Notes
Reason for Late Arrival
My Child Will be Arriving Late At:
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Reason for Late Arrival
(Required)
Illness
Travel
Appointment
Other
Notes
Parent/Guardian Info
Parent/Guardian First Name
(Required)
Parent/Guardian Last Name
(Required)
Parent/Guardian Phone Number
(Required)
*Please note we will call and Email to confirm
Parent/Guardian Email
(Required)
*Please note we will call and Email to confirm
Enter Email
Confirm Email
Comments
Leave any additional questions/concerns here.
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