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Student Absence / Tardy Form

Please complete the form below. Required fields marked with an asterisk *

Date:*

Answer required for "Date:"

Name of Student*

Answer required for "Name of Student"

Grade and Homeroom Teacher*

Answer required for "Grade and Homeroom Teacher"

Parent's Name:*

Answer required for "Parent's Name:"

Parent's Phone Number:*

Answer required for "Parent's Phone Number:"

Please check the reason your child is absent or tardy below.

Answer required for "Please check the reason your child is absent or tardy below."

Illness

Travel

Appointment

Other:

If TARDY, are you purchasing lunch today?

Answer required for "If TARDY, are you purchasing lunch today?"

Yes

Illness - If your child is absent or tardy due to illness, please describe their symptoms below.

Answer required for "Illness - If your child is absent or tardy due to illness, please describe their symptoms below."

Travel - If your child will be absent due to travel please, tell us the dates your child will not be in school.

Answer required for "Travel - If your child will be absent due to travel please, tell us the dates your child will not be in school."

Other - Please tell us the reason your child is absent or tardy.

Answer required for "Other - Please tell us the reason your child is absent or tardy."