Student Absence Excuse Form
Student Information
Last Name
*
First Name
*
Date of Absence(s)
*
-
Month
-
Day
Year
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Homeroom Teacher
*
Reason for Absence
*
Please Select
Illness or Injury
Medical/Dental Appointment
Death in Family
Religious Observance
Other (Please explain below)
Explanation
Parent's Signature
*
Date
*
-
Month
-
Day
Year
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E-mail
*
Attach Documentation as needed
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