Report an Absence

Please complete all the information below. If Student Services has any questions, a staff member will contact the student's parent/guardian for clarification. Thank you.

Name Name First Last
Student Number
Student's Grade
Parent/Guardian Name Parent/Guardian Name First Last
Parent/Guardian Contact Phone Number
Parent/Guardian Email
I am reporting my student for being:

I am reporting my student for being: Absent Tardy
Date(s) of Absence(s) or Tardy:
Total Number of Days Reporting Absent/Tardy for this Entry:
Please note that fraudulently filling out this form will result in a Level 2 Referral for lying to a staff member. This may result in out of school suspension and loss of privileges (parking, attendance at extra-curricular events, etc.). *

Please note that fraudulently filling out this form will result in a Level 2 Referral for lying to a staff member. This may result in out of school suspension and loss of privileges (parking, attendance at extra-curricular events, etc.). * I understand and confirm that I am a parent or guardian filling out this form.
Reason for Absence(s) or Tardiness:

Reason for Absence(s) or Tardiness: Illness of the student Major illness in the immediate family Death in the immediate family Religious holiday in the student's faith Religious instruction, conference, institutes, etc. Court order/subpoena Other (please explain below) - may be excused pending administrative approval
Upload information related to the absence(s) as needed:

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Additional Information