Student Absence Request Form

Absence Request Form
Date in which absence begins

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Date in which absence ends

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
When is the student expected to return for a full-day attendance?

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Please describe the reason for requested students' extended absence.

Write at least 3-4 sentences explaining why this absence is necessary for student.0/70
Please include any necessary notes on student departure and arrival times.

Please wait 1-2 weeks for each request to be processed through our program departments. We will either email or call you once a decision has been made on your request. (Please note that absences in each semester are cumulative. If a student is absent for more than the allocated dates for each semester, they will be subject to repeating the grade level or class.)

Makeup work is subject to the approval of this leave request. Students are responsible for contacting their teachers regarding any missed assignments.
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Should be Empty: