CCS Attendance/Absence Notification Request

Absences, late arrivals, and early departures that are planned in advance must be pre-approved by the administration. Pre-approval via the form below should be requested at least one week in advance. Please consult the CCS Events Calendar (website and ParentsWeb) 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 Date Picker Icon

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

No Yes

End Date *

Month Day Year Date Picker Icon

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

No Yes

Please list all recurring dates:

The administration will determine whether an absence/late arrival/early departure is excused or unexcused according to the guidelines set forth in the Student/Parent Handbook. Unexcused absences invoke academic and disciplinary consequences as defined in the Handbook. A student receives a detention after five counts of unexcused tardiness.

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 *

Illness Medical appointment Dental appointment Personal injury Death of a relative Once-in-a-lifetime event: e.g., wedding/funeral of a family member (explain below) College visit: juniors/seniors only (list college below)

Explanation *

Would You Like Your Child's Work Early? *

Yes No

I hereby accept full responsibility for my child’s absence, realizing that it interrupts his regular instructional program. I agree to take all necessary steps to make arrangements for the completion of all work missed.

Parent/Guardian Signature *

Clear

Office Use Only

Official