Student Extended Absence Reporting Form

Student Extended Absence Reporting Form

To ensure we are accurately reporting absences to the ministry please fill out the form below.
Absence date: *

MonthDayYear
Date
Expected Date of Return (If known, leave blank if unknown and give explanation in the box below):

MonthDayYear
Date
Student's Name:*
Grade/Class:*
Reason for absence:*

Illness or injuryAppointmentEmergencyCultural activityVacationOther - please explain in the provided section below
Please give a short explanation for reason for absence:
I confirm that I am the parent/guardian of the above named student:*

Confirmed - parent/guardian
Should be Empty: