Forms | Alpine Academy of Rockford

LAHS Student Excuse Absence Form

Excuse Absence Form
NOTE: Submitting this form without the required documentation will not excuse your student for the absence.

If the Parent/Tutor is writing an Excuse Note, this should contain a written explanation of the absence and should include a parent phone number (3 written parent notes are allowed per year)
Student Name *

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

First Name Last Name
Email Address
Parent Number Phone Number *
If necessary, the school will verify each online absence excuse form submitted by a parent/guardian by contacting the parent/guardian
Absence Detail
Reason of absence

Student illness/sickness (please provide note from the medical provider) Family member’s illness that requires the student’s temporary help (hospital note) Death in the Family (up to three days) Medical/Dental/Eye Appointment (please provide note from the medical provider) Religious Holiday Student Judicial Proceeding (please attach document from court verifying presence) Documented college visitations (up to three days per year for juniors and seniors) Deployment of a parent or guardian serving in the military (one day for deployment, one day for return and up to 10 days when the service member is on temporary leave at home) Other
Absence From Date *
Absence End Date *
If the Parent/Tutor is writing an Excuse Note, this should contain a written explanation of the absence< parent phone number and signature (3 written parent notes are allowed per year)
Picture of Note (Doctor, Dentist, Judicial proceeding, college visitation, etc) *
Authorization Signature
Parent / Guardian Signature *
Type a question *

By signing above, 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.
Should be Empty:

LAHS Student Excuse Absence Form

Parent Information

Absence Detail

Authorization Signature