Editing previous response:

Please fix the highlighted areas below before submitting.

Absence Note Form

Dear Parent/Guardian:

It is very important to you child's learning that he/she is in school everyday and on time.

Thank you for taking the time to complete this form which will assist in proper attendance accounting and verification of all absences as required by California State Law and California Education Code. Required fields marked *

Once you complete this form, you do not have to contact the school to notify the office of the absence.

Student Name:*

Answer Required

Room Number:*

Answer Required

Teacher Name:*

Answer Required

Date of Absence:*

Answer Required

If your child has been absent multiple days, please list additional dates below:

Answer Required

My child is absent due to the following reason:*

Answer Required

Illness

Medical, Dental, Counseling or Optometry Appointment

Funeral of relative

Other:

If you have a note to verify the absence, you may upload the document below:

Answer Required

Choose a file or drag it here.

Contact Information

Parent Name:*

Answer Required

Mobile Phone

Answer Required

Home Phone

Answer Required

Confirmation Email

Email Required