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Assabet Absence Notification
Assabet Valley Regional Technical High School
I am a
*
Parent/Guardian
Assabet Staff Member
Name of Person Completing Form
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Student Name
*
First Name
Last Name
Student Grade
*
9
10
11
12
Type of form
*
Reporting absence
Requesting dismissal
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Absence Form
Date of Absence
*
-
Month
-
Day
Year
Date
Reason for Absence
*
Illness
Medical Appointment
Legal Appointment
Hospitilization
Registry of Motor Vehicle Appointment
Military Service
Religious Holiday
Bereavement: Death of Family Member
Other
Optional: Additional Information
Please attach any documentation to support your absence (e.g. note from doctor, college visit, etc)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Important Information Regarding Absences
Attention: Parent/guardians will receive an absence call regardless of completing this form. The call is scheduled as a safety measure for your student.
Parent/Guardian Signature
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Dismissal Form
Date of Dismissal
*
-
Month
-
Day
Year
Date
Dismissal Time
*
Hour Minutes
AM
PM
AM/PM Option
Reason for Dismissal
*
Medical Appointment
Legal Appointment
Other
Optional: Additional Information
How will the student be dismissed?
*
Pick up
Student driving self
Name of individual picking up student:
Parent/Guardian Signature
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Please click "review answers" to verify that all form information is accurate. Once you have verified the information, click "submit" to submit your form.
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