Use this form to report absences due to illness, injury, or other valid reasons. Please attach any supporting documentation. Submit at least 10 school days in advance for planned absences, or within 2 days of return for unplanned ones.

Student & Parent Information

Student First Name *

Student Last Name *

Classroom *

Parent/Guardian Name *

Parent Phone *

Parent Email *

Absence Details

Absence Type *

Student Illness or Injury

Medical/Dental Appointment

Family Emergency

Educational Opportunity

Request Type *

One Day

Multiple Days

Start Date *

End Date *

Brief Explanation *

Supporting Documentation

PDF, JPG, PNG (Max 5MB)

Policy Acknowledgment *

I have read and understand the attendance policy

Educational Justification *

Educational Description *

Educational Attestation *

I attest this is educational from the outset

Electronic Signature *

Date: 10/29/2025