2026-2027 STUDENT ABSENCE REPORT FORM

Dear Parent/Guardian,

Please fill out this form if your child will be or was absent from school. Please fill out a separate form for each student.

If you are uncertain about when you should keep your student home, please see the Parent/Student Handbook (pp. 13-14).

Date of Absence

Date

Student's Grade:

Student's Name:

First NameLast Name

Parent/Guardian Reporting the Absence:

First NameLast Name

Parent Email:

example@example.com

Parent Phone Number:

Reason for Student's Absence:

Other

Symptoms:

Other

Other Information:

I state that the information entered above is true and correct, and I understand the following information, taken from the handbook:

Total Absences	Action Taken
5 (before Dec. 1)	Notification Letter 1 sent to family
10	Notification Letter 2 sent to family
15	Required meeting with the Principal
20	Summer school will be required
30	Retention

Absences due to medical reasons must be accompanied by proper medical documentation upon the student's return.

Absences & Extra-Curricular Participation:
Students must be in school by 11:00 a.m. to participate in after-school activities (athletics, dances, holiday programs, etc.).
A student absent on Friday is not eligible to participate in weekend athletic events.
Attendance at band and choir concerts is mandatory for Grades 4–8 — these are part of the curriculum.

Parent/Guardian Signature: