Student Extracurricular Leave of Absence Form
Submit your request for leave of absence due to extracurricular activities. Please provide all required details for review.
Student Full Name
*
First Name
Last Name
Student ID Number
*
Grade/Class
*
Please Select
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Other
Extracurricular Activity Name
*
Type of Activity
*
Please Select
Sports
Music/Arts
Academic Competition
Community Service
Other
Leave Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Leave End Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Leave
*
Advisor/Teacher Name
*
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Supporting Document (e.g., invitation letter, event schedule)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Parent/Guardian Signature
*
Submit Leave Request
Submit Leave Request
Should be Empty: