Student Pre-Arranged Absence

Student Pre-Arranged Absence Pleasant Prairie Elementary

Student attendance in school is not only mandatory but also one of the biggest factors for success. However, we also understand there are times that a student will be gone from school for legitimate reasons that require this form to be completed.

For all pre-arranged absences, regardless of length, please complete this form. This ensures that:  the absence is properly documented as approved,  the teacher is aware of missed class time,  and the student and families are able to obtain the work in order to complete it for credit.

All requests will be reviewed by the teacher and the principal. Each request may or may not be approved due to the student’s academic standing and/or due to attendance concerns that may exist. The maximum allowed days for an approved request are 5 per school calendar year.

Part 1 Parent /Guardian to complete this section.

______Student name Grade Teacher

Will be gone from school from ______to ______(dates) for ______total days.

Reason for Absence: ______

Parent Signature: ______

Part 2 Teacher to complete this section.

Based on student’s academic standing, do you recommend this absence to be approved?

YES NO Comment (if any): ______

______

Teacher Signature: ______

Part 3 Principal to complete this section.

YES Absence Request approved for _____ days. [ ] However, concerns still exist with academic / attendance standing.

NO Absence Request is not approved for ____ days. (If absent, the student’s absence will be recorded as unexcused.) Request was denied due to: [ ] academic concerns [ ] attendance concerns [ ] exceeded maximum allowed

Principal Signature: ______

Office *** Absences recorded in prior year ____ Absences recorded in current school year to date ____ cc: student cumulative folder secretary initials ______updated 8/11