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Date of Absence
Please check this box, if you are choosing to report consecutive day absences
Please list the consecutive absence dates
Student's First Name
Student's Middle Name
Student's Last Name
Grade
Course
- Select -
Advanced Game Design
Advanced Musical Theatre Workshop
American Sign Language 1
American Sign Language 2
American Sign Language 3
American Sign Language 4
AP Chinese
Arabic 1
Arabic 2
Arabic 3
Broadway Dance
Chinese 1
Chinese 2
Chinese 3
Chinese 4
Dance 1
Dance 2
Dance 3
Dance 4
EFEO
Fashion Careers 1
Fashion Careers 2
Game Design & Development
Hip Hop Dance
Intro to Pro Photo
Korean 1
Korean 2
Korean 3
Korean 4
Korean 5
Music Computer Technology 1
Music Computer Technology 2
Musical Theatre Fundamentals
Musical Theater Workshop
Pre-Professional Musical Theatre
Professional Photo 1
Professional Photo 2
Social Media Marketing
TV/Media 1
TV/Media 2
TV/Media 3
Feeder School
- Select -
Annandale High School
Cedar Lane
Centreville
Chantilly
Edison
Fairfax
Falls Church
Hayfield
Herndon
Home
Interagency
Justice
Lake Braddock
Langley
Lewis
Madison
Marshall
McLean
Mount Vernon
Mountain View
Oakton
Robinson
South County
South Lakes
West Potomac
West Springfield
Westfield
Woodson
Reason for Absence
If reporting an ill student, include symptoms, especially if they have fever, nausea, vomiting, sore throat, and/or cough. If your student has a diagnosis from a healthcare provider, please include that information.
Parent/Guardian Contact Information
Parent/Guardian First Name
Parent/Guardian Last Name
Phone Number
Alternative Phone Number
Parent/Guardian Email Address (must be email address listed in SIS for parent)
Confirmation
By submitting this form, you are confirming that you are the parent or legal guardian of the student
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