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Pre-Arranged Absence Request Form for Shekinah Christian School (Partial Day)

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Students who plan to be absent from school for one or more periods for any type of appointment must have this form completed and turned in to the school office at least 5 Days in advance of the absence. A Dr. excuse needs turned in after the appointment.

Please complete the form below. Required fields marked with an asterisk *

Student Name*

(one student per form)

Answer Required

Date of Absence*

Answer Required

Time Leaving*

Answer Required

Time Returning*

Answer Required

Reason for absence:

Answer Required

I fully understand the condition of Pre-Arranged Absences as stated above and certify that I am the parent/legal guardian giving permission for the absence by typing my name below.*

Answer Required

As a parent/legal guardian, if there are questions regarding this form, do you prefer text or email?*

Answer Required

Parent/legal guardian Email*

Answer Required

Parent/legal guardian Number*

Number Required

Please list all of the student’s teachers. Teacher(s) will then sign off indicating they know about the absent and will discuss plans for missed work for the student before they leave.

Please List Class Period and Teacher of Class Missing

Answer Required

Please List Class Period and Teacher of Class Missing

Answer Required

Please List Class Period and Teacher of Class Missing

Answer Required

Please List Class Period and Teacher of Class Missing

Answer Required