Student Name
Parent Name
Parent Email
Parent Phone
Teacher Name
Grade	Choose GradeKindergartenGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6
Date of Absence
Expected Return Date
A.M./P.M.	Absent A.M. OnlyAbsent P.M OnlyAbsent All Day
Reason for Absence	Choose ReasonIllnessMedical AppointmentVacationFamily BereavementOther
	If other please specify:
Additional Information

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