CCS Attendance/Absence Notification Request

CCS Attendance/Absence Notification Request
Absences, late arrivals, and early departures that are planned in advance must be pre-approved via the form below at least 72 hours in advance. Please consult the CCS Calendar of Events when planning medical and dental appointments.
Date Submitted

Month Day Year
Parent/Guardian Email *
Student Name *

First Name Last Name
Grade *
Start Date *

Month Day Year
Is this request for more than one day in a row?

No Yes
End Date (do not include date returning to school) *

Month Day Year
Is this a recurring event (i.e. "every Tuesday at 1:00")?

No Yes
Please list all recurring dates:
Type of Request *
Appointment Time *

: Hour Minutes AM/PM Option
Student Dismissal Time *

: Hour Minutes AM/PM Option
Student Dismissal from School Time

: Hour Minutes AM/PM Option
Student Arrival Back to School Time

: Hour Minutes AM/PM Option
Reason for Request *

Personal injury Personal illness Death of a relative Medical or dental appointment Once-in-a-lifetime event: such as wedding/funeral of a family member (explain below) College visit: juniors/seniors only (list college below), limit 2 per year Driver's license examination Court-mandated appearance or visitation Planned family absence - up to 3 pre-appoved absences (days) per year (NOT during blackout dates publish in Student/Parent Handbook) Other (please explain below)
Explanation
Would You Like Your Child's Work Early? *

Yes No
An absence, late arrival, or early departure will be determined to be excused or unexcused according to the guidelines set forth in the Student/Parent Handbook.

Excused Absence Make-Up Work Policy - The academic work of a student whose absence is excused may be made up for full credit. The make-up period for excused absences equals the length of the absence plus one day. To illustrate, if a student is absent on Monday and Tuesday and returns on Wednesday, the work is due the following Monday. Once the deadline for make-up work has passed, a 3% penalty will be applied for each day the work is late up to a maximum of 30% for grades K5-6 and a 5% penalty up to a maximum of 40% for grades 7-12.

Unexcused Absence Make-Up Work Policy - The academic work of a student whose absence is unexcused receives a letter-grade deduction. Additional late penalties follow the excused absence make-up work policy. Academic work missed due to truancy may not be made up.
I hereby accept full responsibility for my child’s absence, realizing that it interrupts his/her regular instructional program. I agree to take all necessary steps to make arrangements for the completion of all work missed.
Parent/Guardian Signature *

Clear
Please verify that you are human *
Office Use Only
Official
Should be Empty: