Absence Form

1. Parent/Guardian Information

2. Student Information

3. Student Absence Information

4. Absence Comments

I certify that the provided information is true. I give permission to the school to verify the provided above information. I understand that falsifying absence from a class is a violation of the "Policy J5: Student Discipline, Required Behavior and Expectations". I understand that student will be subjected to a disciplinary action in the event the above facts are found to be false.