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Request for Excused Absence-Educational Trip
2/13/2014

  

GREENVILLE AREA SCHOOL DISTRICT

9 Donation Road, Greenville, PA 16125

Where Every Child Is A Candidate For Greatness

 

Request For Excused Absences From School For A Pre-Planned Educational Tour or Trip

 

Student’s Name ____________________________ Grade:________     Date of Application:_______________

 

Date(s) of Proposed Absence_________________ to _______________ Number of days Requested_______

 

PER PDE REGULATIONS, FIVE (5) DAYS PER YEAR WILL BE PERMITTED

 

Person(s) directing and/or supervising student during above absence:

 

Name________________________________________________Phone____________________________

 

Students are responsible for meeting with each teacher before leaving and for making up all school work within Five Days upon return.

 

DESTINATION:____________________________­­­­­­­­­­­­­­­­­­_____________________

                                                (city/state/country)

Itinerary of trip. Include experiences which could be educational in nature and will, therefore, provide the student with some valuable experience outside of the classroom. (Use back if more space is necessary)

 

__________________________________________________________________________________________________________________________________________________________________________________________

List names, grades and school of other school-age students in your family enrolled in Greenville Area Schools and participating in this experience.

 

Name_____________________________________ Grade______   School__________________________

 

Name_____________________________________ Grade______   School__________________________

 

Name_____________________________________ Grade______   School__________________________

 

Were there prior requests this school year?_______   Dates_______________________________________

 

I certify all of the above information to be true.

 

 

________________________________________     ____________________________

     Signature of Parent/Guardian                                           Date

 

Note: This form is to be used in place of a written excuse.

 

**************************************************************************************

FOR SCHOOL USE ONLY

 

Prior Requests and Dates:_________________________________________________________________

 

Approval:____________     Disapproval:__________      Date:___________________________________

 

Conditions:   Student will get assignments ahead of time, make up work upon return, and write a short one-  

                     page summary of the trip.

 

__________________________________________                            _______________________________________

Signature of Principal                                                                    Superintendent’s Signature

 

Original for office file. Copies to parents and superintendent.

 

GASD-0017 9/28/10