OHA Leave Form
Parents/caregivers are required if students are expected to be away from campus outside of curfew.
Student Name:
*
First Name
Last Name
Parent or Guardian Name:
*
First Name
Last Name
Parent or Guardian Email (Must match email on file):
*
example@example.com
Phone Number:
*
Format: (000) 000-0000.
Leave Start Date:
*
-
Month
-
Day
Year
Date
Time
*
Hour Minutes
AM
PM
AM/PM Option
Leave Return Date:
*
-
Month
-
Day
Year
Date
Time
*
Hour Minutes
AM
PM
AM/PM Option
Reason for absence:
Submit
Should be Empty: