Tardy/absence Excuse Form

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Newburgh Free Academy
Newburgh Free Academy
Tardy/Absence Excuse Form
Tardy/Absence Excuse Form
Student Name_______________________ ID#______________
Student Name_______________________ ID#______________
Homeroom_______ Date Tardy/Absence Began________ No. of Days_______
Homeroom_______ Date Tardy/Absence Began________ No. of Days_______
Check Reason:
________Tardy
________Absent
Check Reason:
________Tardy
________Absent
______Student was ill
______Court Attendance
______Student was ill
______Court Attendance
______Emergency Dental/Medical Appt
______Religious Observance
______Emergency Dental/Medical Appt ______Religious Observance
______Death in Immediate Family
______Quarantine
______Death in Immediate Family
______Quarantine
______Approved School Activities
______Admin or Nurse’s Directive
______Approved School Activities
______Admin or Nurse’s Directive
_______Military Obligations
______College Visitation
_______Military Obligations
______College Visitation
Other:________________________________________________________
Other:________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
____________________________
____________________________
Signature of Parent or Guardian
Signature of Parent or Guardian
Newburgh Free Academy
Newburgh Free Academy
Tardy/Absence Excuse Form
Tardy/Absence Excuse Form
Student Name_______________________ ID#______________
Student Name_______________________ ID#______________
Homeroom_______ Date Tardy/Absence Began________ No. of Days_______
Homeroom_______ Date Tardy/Absence Began________ No. of Days_______
Check Reason:
________Tardy
________Absent
Check Reason:
________Tardy
________Absent
______Student was ill
______Court Attendance
______Student was ill
______Court Attendance
______Emergency Dental/Medical Appt
______Religious Observance
______Emergency Dental/Medical Appt ______Religious Observance
______Death in Immediate Family
______Quarantine
______Death in Immediate Family
______Quarantine
______Approved School Activities
______Admin or Nurse’s Directive
______Approved School Activities
______Admin or Nurse’s Directive
_______Military Obligations
______College Visitation
_______Military Obligations
______College Visitation
Other:________________________________________________________
Other:________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
____________________________
____________________________
Signature of Parent or Guardian
Signature of Parent or Guardian

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