Elementary School Pre-Excused Absence Form


Please excuse my student, __________________________, in
Grade ________ / _____________________ from school on the
(Teacher name)
following dates (and time if applies) _______________________
for the following reason:
Doctor / Dentist Appointment
Other _____________________________________
Students are expected to obtain their assignments before they depart
and they are expected to have the work completed and turned in
upon the first day back to school.
Parents: Please sign this form and give it to the office. After the
upcoming absence is recorded, the form will be given to your child’s
teacher. The teacher will give your student their homework the day
before their absence.
Parent Signature _____________________
Date ________
Teachers: Please sign to acknowledge that the student has received
his/her homework and has returned this form to the school office.
Teacher Signature _____________________ Date ________


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