Absences

1.	Student Information - Please fill out one form for each student.* Name & Homeroom Enter at least 3 responses.
	Date   First & Last Name   Homeroom Teacher Name

2.	Absence Reason Reason for Absence
	Illness    Doctor/Dental Appointment Please provide Dr. note    Vacation - 1 Week Prior Notification Required    Funeral    Other, please specify

3.	Homework Request* Homework
	Please send homework to the office   Please send homework home with another student   Other Student's Name   Other Student's Homeroom Teacher Homework   --Please Select--NoneYesNo   --Please Select--NoneYesNo