Please fill out this form to submit an absence, late arrival, or early dismissal. The school may contact you to confirm. When reporting an extended absence, please be advised that it is the student/parent responsibility to contact teacher(s) for any missed work, to reschedule missed tests, and/or to request extensions on assignments that may be due during planned time away.Student InformationLast name*First name*Grade*Person Reporting AbsenceName*Phone number*Email address*Relationship to student*Please selectMotherFatherLegal GuardianOtherPlease explain*Absence InformationStudent will be*AbsentLateDismissed EarlyDate*End Date(if student will be absent for more than one day)Arrival timeDismissal timeReturn time(if student will be returning to school)Reason*Please selectIllnessAppointmentVacationOtherPlease explain*SubmitThis field should be left blank