JHHS - Student Absence Excuse Form

Student Absence Excuse Form

For reporting late arrivals, early dismissals, and full day absences. *Please note: this form may ONLY be submitted by the parent/legal guardian of the student, as listed on our student contact information.

	STUDENT'S FIRST NAME:*

	STUDENT'S LAST NAME:*

	ABSENCE TYPE:*
	ABSENCE TYPE:* Full Day Absence Early Dismissal Late Arrival

	DATE(S) OF ABSENCE:* Include all dates missed by student.

	REASON FOR ABSENCE:* If you have a note from a doctor, please provide it to the school.

	FOR EARLY DISMISSAL: Enter time of dismissal

	FOR EARLY DISMISSAL: Enter name of person picking student up (first and last name). *ID check upon pick up.

	FOR LATE ARRIVALS: Estimated arrival time

	YOUR NAME: (Must be a parent/guardian listed on student contact list)*

	YOUR RELATIONSHIP TO STUDENT: (Mom, Dad, Guardian, etc.)*

	YOUR PHONE NUMBER AND/OR EMAIL ADDRESS: (Must match information provided on student contact list)* Please provide contact information in case we need to contact you regarding your child's absence.

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