Absent, Tardy, Early Dismissal & Planned Absence
All Planned Absences must be submitted at least five days prior to planned absences.
Type of Submission
*
Please Select
Absent
Tardy
Early Dismissal
Planned Absence
Student First & Last Name
*
Email
*
example@example.com
Number of Days Absent
*
Grade
*
Please Select
K3
K4
K5
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Please ensure dates requested are 5 days in advance.
Date of Absence
*
/
Month
/
Day
Year
Date
Dates FROM
*
/
Month
/
Day
Year
Date
Dates TO
*
/
Month
/
Day
Year
Date
Dates 3-4 FROM
*
/
Month
/
Day
Year
Date
Dates 3-4 TO
*
/
Month
/
Day
Year
Date
Dates 5 FROM
*
/
Month
/
Day
Year
Date
Dates 5 TO
*
/
Month
/
Day
Year
Date
Dates 6 FROM
*
/
Month
/
Day
Year
Date
Dates 6 TO
*
/
Month
/
Day
Year
Date
Dates 7-11 FROM
*
/
Month
/
Day
Year
Date
Dates 7-11 TO
*
/
Month
/
Day
Year
Date
Dates 12 FROM
*
/
Month
/
Day
Year
Date
Dates 12 TO
*
/
Month
/
Day
Year
Date
Homeroom Teacher
*
Time of Pickup or Arrived
*
Hour Minutes
AM
PM
AM/PM Option
Reason
*
Person Picking Up
*
First Name
Last Name
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Signature
*
Submit
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