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Student Absence / Tardy Form

Please complete the form below. Required fields marked with an asterisk *

Date:*

Answer Required

Name of Student*

Answer Required

Grade and Homeroom Teacher*

Answer Required

Parent's Name:*

Answer Required

Parent's Phone Number:*

Answer Required

Please check the reason your child is absent or tardy below.

Answer Required

Illness

Travel

Appointment

Other:

If TARDY, are you purchasing lunch today?

Answer Required

Yes

Illness - If your child is absent or tardy due to illness, please describe their symptoms below.

Answer Required

Travel - If your child will be absent due to travel please, tell us the dates your child will not be in school.

Answer Required

Other - Please tell us the reason your child is absent or tardy.

Answer Required