<p> Student Pre-Arranged Absence Pleasant Prairie Elementary</p><p>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.</p><p>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.</p><p>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.</p><p>Part 1 Parent /Guardian to complete this section.</p><p>______Student name Grade Teacher</p><p>Will be gone from school from ______to ______(dates) for ______total days.</p><p>Reason for Absence: ______</p><p>Parent Signature: ______</p><p>Part 2 Teacher to complete this section.</p><p>Based on student’s academic standing, do you recommend this absence to be approved?</p><p>YES NO Comment (if any): ______</p><p>______</p><p>Teacher Signature: ______</p><p>Part 3 Principal to complete this section.</p><p>YES Absence Request approved for _____ days. [ ] However, concerns still exist with academic / attendance standing.</p><p>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</p><p>Principal Signature: ______</p><p>Office *** Absences recorded in prior year ____ Absences recorded in current school year to date ____ cc: student cumulative folder secretary initials ______updated 8/11</p>