Liberty Elementary Absence Form
Liberty Elementary Absence Form
Absences may be verified by phone.
Child's Name
Child's Name
*
First
Last
Parent/Guardian Name
Parent/Guardian Name
*
First
Last
Contact Phone
Contact Phone
*
-
###
-
###
####
Contact E-mail
*
Child's Teacher
*
Date(s) of Absence
*
Reason for Absence
*
Illness - Dr.'s Note
Illness - No Dr.'s Note
Family Emergency - Unexcused
Out of Town - Unexcused
Family Funeral
Other - Please Explain
Please provide Dr.'s note when applicable.
Notes or Explanation