East School Program Pre-Arranged Absence Form

Elementary Pre-Arranged Absence Form

Please be aware that your student's academic status and attendance record will be taken into account as part of the approval process. Also, please understand that notification of less than one week will likely hinder the teacher's ability to provide the necessary make-up work and students may lose credit.

An administrator determines if pre-arranged absences are excused or unexcused per D20 Policy JH. Please remember students who have 4 or more total days of unexcused absences a month or 10 or more unexcused absences annually are considered habitually truant. See Policy JHB-TCA for further information.

1.	Today's date:*
	mm/dd/yyyy

2.	Child's Name:*

3.	Child's Teacher:*

4.	Dates of proposed absence (mm/dd/year - mm/dd/year):*

5.	Reason for absence:*

	I UNDERSTAND THAT I AM RESPONSIBLE TO GET ALL ASSIGNMENTS FROM ALL OF MY CHILD'S TEACHERS, AND TO SEE THAT THEY ARE COMPLETED ACCORDING TO THE REQUIRED STANDARDS AT THE CLASSICAL ACADEMY.

6.	Please type your name in the following field as your digital signature.*

East Elementary Pre-Arranged Absence Form