Clone of Main Street Absence Verification Form

Absence Verification Form
We're sorry to hear that your child is or will be absent. Every day of school missed can have a significant impact on your child’s education. To help you and your child stay engaged in learning while they are out of school, and also to support your child in accessing independent study materials to support them in maintaining a positive attendance record, your child now has the opportunity to complete independent study for coursework for as little as one day absent.

Those students who complete the required number of minutes of independent study will receive attendance credit and will not be marked absent.
Student Name:*

First NameLast Name
Student's Grade:*
Student's Teacher:*
Guardian Name:*

First NameLast Name
Guardian Email Address:*
example@example.com
Date Absent (From)*

MonthDayYear
Date
Date Absent To (If more than one day)

MonthDayYear
Date
Reason for Absence*

Sick/IllFamily EmergencyOther
If your child completes independent study, their absence will be counted as a day of attendance, so long as they complete the work associated with independent study for each day of absence.
Do you wish for your child to receive attendance credit by completing independent study (digital independent study materials will be provided)?*

YesNo
Please check the boxes below in order to acknowledge your understanding regarding the requirements and implications of independent study:
I understand that the major objective of independent study is to enable my student to keep current with their studies for the period during which they are absent.
I understand that independent study is an educational alternative for my child that I have voluntarily selected.
I understand that while short-term independent study supports my student in continuing their education and maintaining a positive attendance record, there is no substitute for actually being present in school.
I understand that all work must be completed at/by the time the student returns to school after being absent in order for my student to receive attendance credit.
I acknowledge that my student cannot receive short-term independent study credit for more than 14 days (cumulative) days in a single school year.
Teacher Email Address
example@example.com
Signature

Clear
Should be Empty:

Absence Verification Form

If your child completes independent study, their absence will be counted as a day of attendance, so long as they complete the work associated with independent study for each day of absence.

Please check the boxes below in order to acknowledge your understanding regarding the requirements and implications of independent study: