Define "Other": 

Additional Comments:

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PARENT/GUARDIAN INFORMATION

 

Parent's Full Name: 

Parent's Email Address: 

Phone Number:  

Phone Number Type:  Home  Cell  Work

 

*By checking the box below, you are certifying that you are in fact the parent or legal guardian of the child in question, have the legal authority to make such decisions, and do provide the reasons for the absence in question.  

Signature Certification *

 

By submitting this form, you do NOT need to call the office to report the absence NOR do you need to write out a physical note. This report will act as your note to the office.

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