NOTIFIED ABSENCE FORM

Entered

La Jolla Country Day School

NOTIFIED ABSENCE FORM Print Name

Grade

Date(s)

Mark one (X):

Full Day

Partial Day

Start time if partial.

Reason

I understand that I am responsible for all of the work I will miss and all of the information given in class during this time. Student's signature

Date

Notify teachers of the absence. Write “free” or leave blank if no class is missed. Teacher’s Name STEP 1

A Block

B Block

C Block

D Block

E Block

F Block G Block STEP 2

Parent’s Signature

STEP 3

US Dean or Director’s signature

STEP 4

Return completed form to the Upper School Office.

Teacher’s Signature