Attendence Request Form
Request an excused absence or tardy here:
Parent Name
*
First Name
Last Name
Type of Request
*
Please Select
Absence
Tardy
Excused Absence/Tardy Date
*
-
Month
-
Day
Year
Date
If absence requested is beyond one school day, please specify how many total school days you are requesting an excused absence:
If requesting an Excused Tardy- Time requesting to be excused:
Hour Minutes
AM
PM
AM/PM Option
Until
until
Hour Minutes
AM
PM
AM/PM Option
Student Full Name (1)
*
First Name
Last Name
Grade (1)
*
Please Select
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Student Full Name (2)
First Name
Last Name
Grade (2)
Please Select
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Student Full Name (3)
First Name
Last Name
Grade (3)
Please Select
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Student Full Name (4)
First Name
Last Name
Grade (4)
Please Select
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Reason For Absence
*
Please Select
Illness
Illness of an immediate family member
Scheduled Doctor/Dentist Appointments
Required Court Appearance
Students having or suspected of having a communicable disease or infestation that can be transmitted
Special Event (includes public function, educational enrichment activity, conferences)
Death in the Family
Explain Reason For Absence
*
If medically related, please submit your doctors note here:
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Parent Phone Number
*
Please enter a valid phone number.
Parents, please leave a voice note with your name, child's name, grade, date of absence/tardy and reason for absence. Students are prohibited from making false reports by posing as a parent to excuse absences or tardiness. Should this occur, the student will be subject to the consequences outlined in the Jewish Academy's Student Code of Conduct
*
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