EmailMeForm
Elementary School Absence Request/Excuse
REQUEST FOR STUDENT ABSENCE
EXCUSE FOR STUDENT ABSENCE
This form must be used to excuse a student for one or two days of sickness.
Remember, one or two days of sickness may be excused by a parent using this form, while 3 or more days must be excused with a verified doctor’s note.
Northlake Christian policy states that students may miss ONLY 10 days in a year (Elementary School), except in the case of extenuating medical or family emergency circumstances which have to be approved by the administration.
Student Name
*
First
Last
Student's Grade
*
Please select
PreK4
Junior Kindergarten
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Name of Parent Filling out this form
*
First
Last
Parent's Email
*
This is a:
*
Request for FUTURE absence
Excuse for PREVIOUS absence
Beginning Date of Absence
*
MM
/
DD
/
YYYY
Ending Date of Absence (if applicable)
*
MM
/
DD
/
YYYY
Absence Reason (please give as much detail as possible)
*
By checking this box, I certify that this absence is verified for the reason above.
*
Electronic Verification
This request for absence will be sent to the appropriate administrator for approval.
