MSHS PRE-PLANNED ABSENCE APPROVAL FORM

MSHS PRE-PLANNED ABSENCE APPROVAL FORM
Dean Approval

ApprovedDenied
Date of Consideration

MonthDayYear
Date
Administrative Signature

Clear
Student Name:*
Grade
Email*
example@example.com
Pre-Planned Absence Policy as defined in the ACA Handbook:

“The school must be notified at least one week prior to any planned absences (trips, family vacations, etc to allow the student to obtain makeup work from the teachers. Students must submit a Planned Absence Form, approved by the principal, at least one week prior to their absence(s This form is available in the school office. If this form is not complete and approved before the student’s departure any work missed during the student’s absence may not be given credit. It is the student’s responsibility to make up all work missed. If planned absences cause the student to exceed the absence restriction, the school administration reserves the right to review such instances on a case-by-case basis.”

Additionally, please review the following legally mandated Absence Policy:

“Ten (10) absences are allowed each semester (due to block scheduling - that would only allow 5 blue days and 5 gold days per semester); After ten absences, the student may not receive credit for the course.”

Please note that completion of this form does not make the absence excused.
Dates of Absence:*

MonthDayYear
Date
to*

MonthDayYear
Date
Total # of School Days:*
Please mark the reason for absence: *documentation may be required*

College Visit (2 days for juniors, 3 days for seniors) *documentation requiredBereavement (3 days) *documentation requiredRequired Court Appearances *documentation requiredOther:
College Visiting
In signing this form, I confirm that I have read and agree to uphold the Pre-Planned Absence Policy and the general Absence Policy as detailed on this form. I understand that if my student exceeds 5 blue absences or 5 gold absences, they may not receive credit for their courses. I also understand that approval is completely at the discretion of the administration of ACA and that I must submit required documentation. If the required documentation is not provided, I understand that the absence(s) will not be approved.
Clear
MonthDayYear
Date
Type a question

Judson Stubbs
Should be Empty: