CCS Attendance/Absence Notification Request

CCS Attendance/Absence Notification Request
Planned absences, late arrivals, and early departures should be submitted using the form below at least 72 hours in advance for approval. If advance notice is not possible, the form should still be completed as soon as the information is available. Please refer to the CCS Calendar of Events for testing or blackout dates when scheduling appointments or planned absences.
Date Submitted

MonthDayYear
Parent/Guardian Email*
Student Name*

First NameLast Name
Grade*
Please add additional student names AND grade that will also be absent.
Start Date*

MonthDayYear
Is this request for more than one day in a row?

NoYes
End Date (do not include date returning to school)*

MonthDayYear
Type of Request*
Appointment Time*

:HourMinutesAM/PM Option
Student Dismissal Time*

:HourMinutesAM/PM Option
Student Dismissal from School Time

:HourMinutesAM/PM Option
Student Arrival Back to School Time

:HourMinutesAM/PM Option
Reason for Request*

Personal injuryPersonal illnessDeath of a relativeMedical or dental appointmentOnce-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 yearDriver's license examinationCourt-mandated appearance or visitationPlanned 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? (If the absence is excused and request made one week in advance.)

YesNo
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: