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Excuse Absence Notice

Complete this form to report your child's absence.

**Note to Parents/Guardian: Please be aware that DC Law states that excuse notes written by parents must be turned into school staff within five days following a student's return from an absence to be excused.

Parent / Guardian's Name*

Answer Required

Student's Name*

Answer Required

Student Grade*

Answer Required

START Absence Date *

Answer Required

END Absence Date*

Answer Required

Please select the reason why your child missed school (required).*

Answer Required

Student illness/sickness (if a student is absent for five (5) or more cumulative days per term, further documentation is required.

Medical/dental appointment (please provide note from the medical provider)

Student judicial proceeding (please provide document from court verifying presence)

Religious holiday

Death in the family

OTHER (If you selected "other", please provide details below. Please understand that under DC law, only certain absences may be accepted as excused absences.

Answer Required