Elementary School Absentee Form

This form must be completed by the parent/guardian of the absent student by the end of the following day. Please note submitting this form does not guarantee the absence will be excused.

Please allow 2-3 days for the absence to be excused. In addition, Scholars who are absent for 4 or more consecutive days must provide a doctor's note to excuse the absence. For more information on policies pertaining to absences, tardies and more please visit the Student Handbook.

Student Name Student Name First Last
Grade Level
Date(s) of Absence
Has the student been absent for 4 or more consecutive school days?

Has the student been absent for 4 or more consecutive school days? Yes - Please upload the doctor's note below (You must attach a doctor's note in order for the absence to be excused). No
Reason for Absence
If you have a Doctor's Note or other official document that you'd like to submit to support the absence of your child, please upload file here:

Attach Files
Parent/Guardian Name Parent/Guardian Name First Last
Parent/Guardian Email
Parent/Guardian Signature (Draw your signature into the box below. Please note that this is a legal document. No one may sign in place of the parent or guardian.)

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Signature Date Signature Date / MM / DD YYYY