Elementary School Excuse - Blank
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1
2Today’s Date
JOHNSON CITY ELEMENTARY SCHOOL EXCUSE BLANK
Student’s Name
Grade
Homeroom
On the following date(s)
my child
was Absent
was Late
Time of Entry:
is to be Dismissed at:
Reason for Absent/Tardy/Early Dismissal:
Death in
Court
Doctor’s
Illness
Family
Appearance
Appointment
Religious
Observance
Other
(Please specify reason below)
Signature:
Parent/Guardian
This is a 2 sided form. Directions and other information is located on the back side of the form.
Today’s Date
JOHNSON CITY ELEMENTARY SCHOOL EXCUSE BLANK
Student’s Name
Grade
Homeroom
On the following date(s)
my child
was Absent
was Late
Time of Entry:
is to be Dismissed at:
Reason for Absent/Tardy/Early Dismissal:
Death in
Court
Doctor’s
Illness
Family
Appearance
Appointment
Religious
Observance
Other
(Please specify reason below)
Signature:
Parent/Guardian
This is a 2 sided form. Directions and other information is located on the back side of the form.
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