Report an Absence/Tardy

Please complete all the information below. If Student Services has any questions, a staff member will contact the students's parent/guardian for clarification. Thank you.

Student Name
Student Number
Student's Grade

Student's Grade 6th 7th 8th
Parent/Guardian Name
Parent/Guardian Contact Phone Number
Parent/Guardian Email
Date(s) of absence(s)
Please note that fraudulently filling out this form will result in a Level 2 Referral for Lying to a Staff Member. This may result in out of school suspension and loss of privileges (attendance to extra-curricular events, etc...)

Please note that fraudulently filling out this form will result in a Level 2 Referral for Lying to a Staff Member. This may result in out of school suspension and loss of privileges (attendance to extra-curricular events, etc...) I understand and confirm that I am a parent or guardian filling out this form.
I am reporting my student for being:

I am reporting my student for being: Absence Tardy
Reason for Absence(s) or Tardiness:

Reason for Absence(s) or Tardiness: Illness of the student Major illness in the immediate family Death in the immediate family Religious holiday Court order/subpeona Other (please explain below) - May be excused pending administrative approval:
Please upload Dr.'s note here.

All absences are considered unexcused until an excuse note is submitted to Student Services or via the "Report Student Absence" form. Students must submit an excuse within three days of last absence.

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