Absence/Tardy Form

WSD Absence/Tardiness Note

Note: This note must be submitted within three (3) days of absence to be excused.

Last Name: _____________________First Name: _____________________________

Grade: ____ Teacher/Homeroom:_____________________________

ABSENCE: Date(s): _____________________________

LATE: _____________________________Date: ________________________________Time: __________

REASON FOR ABOVE: _____________________________________________________________________

Parent/Guardian Signature: ___________________________________