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Prearranged Absence PDF Print E-mail
Written by Angela Brown   
Wednesday, 09 February 2011 13:11

Bloomfield Jr/Sr High School

Prearranged Absence with Administrative Approval

This form must be completed and returned 5 SCHOOL DAYS in advance of the absence 

Student Name: _________________________     Date:____________

The above-named student will be absent from school on: _____________

Reason for absence:__________________________________________

The student recognizes that it is his/her responsibility to secure all make-up work required by his/her teachers.  A student must be passing ALL classes to be excused for this absence.  Students not passing will NOT be excused to be absent from school. If approved, this is an excused absence and will count toward accumulated EXCUSED absences.

This form should be signed by each teacher so the teacher has prior knowledge of the absence and can plan accordingly.

  Period        Class Passing/Not Passing    Teacher Signature
Period 1 ______________   ____________________ _________________
Period 2 ______________   ____________________ _________________
Period 3 ______________   ____________________ _________________
Period 4 ______________   ____________________ _________________
Period 5 ______________   ____________________ _________________
Period 6 ______________   ____________________ _________________
Period 7 ______________   ____________________ _________________

  

_____________________________    ____________________________
Student Signature                                             Parent Signature

 

_________________________________ 
            Principal Signature

__ Approved   ____ Denied - Reason_________________________________________ 

                                                                                                               

Last Updated on Wednesday, 09 February 2011 13:22