Attendance Tracking Form - Leon County Schools

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LCS-9460-1162
A t t e n d a n c e T r a c k i n g F o r m
NOTE: This form is to be initiated by the classroom teacher.
__________________________
_______________________
_________________
School Name
Teacher’s Name
Referral Date
Student’s Name and Student No.
Primary/Homeroom
Sex
Race
Date of Birth
Teacher
Male
Asian
Islander
Black
Multi
Female
Hispanic White
Parent(s)/Guardian(s) Name
Address – include Zip Code
Phone Numbers
Home:
____________________________________
Work:
____________________________________
Cell:
____________________________________
Days Absent ____/____
Days Tardy ____/____
Days Leaving Early ____/____
Unex Ex
Unex Ex
Unex Ex
Teacher’s Attempts to Involve Parents
Dates
Results
Phone Calls
Dates
Results
Notes Sent Home
Dates
Results
E-mails
Dates
Results
Conferences
Teacher’s Signature ______________________________________
Date: _________

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