Extended Absence
Complete this if your scholar(s) will be absent for three or more days. The submission of this document is a request and is not guaranteed approval. The request must be reviewed by the Attendance Department and can take up to 3 school days. Please gather documentation to support the scholar(s) absence.
Student's Name
*
First Name
Last Name
Grade Level
Please Select
KK
1st
2nd
3rd
4th
5th
6th
7th
8th
Select the Grade
Requesting Parent's Name
*
First Name
Last Name
Date Absence Begins
*
-
Month
-
Day
Year
Date
Date of Return
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Reason for Absence
*
Please Select
Family Emergency
Death in the Family
Religious Observation
Medical Concern
Other
If "Other" please provide details about the reason for the absence.
Please describe, in detail, the reason for your request
*
(Optional) List any other DIA students that will be absent
Include the Student(s) Name(s) and Grade Level(s)
Supporting Documentation Submission
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If you have any issues uploading here, try emailing it to diattendance@duboisintegrityacademy.com. Documentation must be submitted within three days of the scholar's return to school . Without supporting documentation the request is less likely to be reviewed.
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