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Student Absence Form
Child's First Name
*
Child's Last Name
*
Parent's First Name
*
Parent's Last Name
*
Parent Primary Phone
*
Parent Email
*
Grade Level
*
Pre-Kindergarten
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Enter Additional Siblings Absent Below If Necessary
Dates of Absence
Date Absent From:
Month
Day
Year
Date Absent To:
Month
Day
Year
Reason for Absence
*
Sick
Dr. Appointment
Travel/Vacation
Transportation Issues
Weather
Other - Please explain below
Comments
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