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Registration
Assembly Bill 195
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Report an Absence
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Report an Absence
Report an Absence
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Parent/Guardian Name
*
required
First Name
Last Name
Student Name
*
required
First Name
Last Name
Grade
*
required
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
Date of Absence
*
required
(Must contain a date in MM/DD/YYYY format)
Reason for Absence
*
required
Medical with Doctor's Note
Medical without Doctor's Note
Family Emergency
Other (Please write the reason below).
Other Reason for Absence
Please upload the Doctor's Note below.
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