Report an Absence

REPORT AN ABSENCE
Please note that the School may contact you in order to confirm your child's absence.
Student Information
Student Name *

First Name Last Name
Grade *
Parent / Guardian Information
Parent / Guardian Name *

First Name Last Name
Email Address
example@example.com
Phone Number
Absence Detail
Absence From Date *

Month Day Year
Date
Absence End Date *

Month Day Year
Date
Reason Why *
Attach Note, If Applicable

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Authorization Signature
Authorization *

By signing below, I certify that I am the Parent or Legal Guardian of the student named above and that all the information provided is true and correct to the best of my knowledge.
Parent / Guardian Signature *

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Legacy Christian Academy

27680 Dickason Drive
Valencia, CA 91355
Phone: 661.257.7377
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REPORT AN ABSENCE