Online Form for Absence/Lateness/Early Release

Excuse for Absence/Lateness/Early Release

Excuse For Absence, Lateness, or Early Dismissal

Please fill in the information requested below. An explanation from a student's parent/guardian for each absence/lateness/early release is required by Pennsylvania law. --Thank you

Do Not Use This Form if you are reporting Vacation (5 days max per school year). Please contact your grade level principal:Upper School, Ms. Boyd or Lower School, Mrs. Herman

Student's Last Name:

Student's First Name:

Grade:

Attendance Event:

Date'of Attendance Event:

Reason for Absence/Lateness/Early Release*:

Absence=All Day, Lateness=Will not start the day, Early Dismissal=Start the day but will be out for all or part of the rest of the day (please estimate return time below in "early dismissal" section)

*If Early Release:

Time Out:

Time Back In (Estimated): (If your student will not be returning, use 3:30 pm)

Full Name of Person Picking Up Student:

Please be sure that person brings along their driver's license for identification.

Your Name**:

Email:

Phone:

**By submitting your name on this form, you are affirming that you are the parent/legal guardian of the listed student and that all information listed above is accurate and truthful.

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Renaissance Academy
Building Lifelong Learners

Online Form for Absence/Lateness/Early Release

Excuse For Absence, Lateness, or Early Dismissal

Renaissance Academy

Renaissance AcademyBuilding Lifelong Learners

Online Form for Absence/Lateness/Early Release

Excuse For Absence, Lateness, or Early Dismissal

Renaissance Academy

Renaissance Academy
Building Lifelong Learners