Student Attendance Report
Please report Absence, Late Arrival, or Early Dismissal (one per child per day)
Child's Name
*
First Name
Last Name
Homeroom:
*
Please Select
KA-Klein
KB-Rozum
KC-Smith
1A-MacDonald
1B-Parrell
2A-Henman
2B-Leone
3A-Bittikofer
3B-Gast
4A-Dichtel
4B-Murphy
5A-Balagna
5B-O'Leary
6A-Peters
6B-Reynolds
7A-Elmer
7B-Lillemoen
8A-Dosch
8B-Moskus
Date of Attendance Event:
*
-
Month
-
Day
Year
Insert Date of Absence, Late Arrival or Schedule Early Dismissal
Reporting Information
*
Late Arrival
Early Dismissal
Absence
Reporting Information
Please complete for illness or other reason for absence
Reason for Absence:
*
Please Select
Late Arrival (Complete Below)
Early Dismissal (Complete Below)
Cold
Fever
Sore Throat
Headache
Strep Throat
Stomach Ache
Influenza
Influenza A
Influenza B
Asthma
Pink Eye
Pertusis (Whooping Cough)
Scarlet Fever
Hand, foot & mouth disease
Head lice
Chicken Pox
Measles
Covid 19
Vacation (w/notice to teachers)
Athletics (St. Patrick Sport)
Athletics (Non-St. Pat's)
Funeral
OTHER (Comment at bottom)
Late Arrival
Child will be arriving late, insert details below
My child will arrive late today
Appointment
Other
Anticipated time for arrival:
Pease enter estimated time for arrival
Early Dismissal
Please complete this section NO LATER THAN 2:45 pm
Reason for Early Dismissal
Appointment
Illness
Sports (St. Pat's)
Sports (Non-St. Pat's)
Vacation
Other
Early Dismissal Time (M-TH)
Please Select
9:30 am
10:15 am
11:00 am
11:50 am
12:30 pm
1:15 pm
2:00 pm
2:45 pm
3:00 pm
Early Dismissal Time (Friday ONLY)
Please Select
9:30 am
10:00 am
11:15 am
11:50 am
12:30 pm
1:15 pm
2:00 pm
2:45pm
3:00pm
Return after appointment?
YES
NO
Other
Parent Reporting Attendance Information
Inser name, email and phone of reporting parent
Parent Name
*
E-mail:
*
Comments:
Submit
Should be Empty: