Right click here to print this page.
Absence Form
2/21/2014
  Today's Date: ______________________       Today's Date: ______________________  
                       
  GREENVILLE AREA SCHOOL DISTRICT       GREENVILLE AREA SCHOOL DISTRICT  
  REPORT OF ABSENCE FORM       REPORT OF ABSENCE FORM    
                       
Student's Name: __________________________________________ Student's Name: __________________________________________
Student's Grade:__________

 

Absence Date(s): ______________________

Student's               Grade: __________

Absence Date(s): ______________________
    (Please check appropriate box)           (Please check appropriate box)      
  Tardy Absence Early Dismissal     Tardy Absence Early Dismissal
    (Please check reason for absence)           (Please check reason for absence)      
     Illness              Illness        
     Death in immediate family            Death in immediate family      
     Impassable roads            Impassable roads      
     Religious service or event            Religious service or event      
     Medical appintment or testing            Medical appintment or testing    
     Absence pre-approved by principal          Absence pre-approved by principal    
     College visitation-not to exceed 3 per year          College visitation-not to exceed 3 per year  
         Applies to Juniors & Seniors only              Applies to Juniors & Seniors only    
         Additional form required - available in office            Additional form required - available in office  
     Absence due to pre-approved educational travel        Absence due to pre-approved educational travel  
         Additional form required - available in office            Additional form required - available in office  
     Other              Other        
         Please explain on reverse side              Please explain on reverse side    
                       
Signature: _________________________________________________ Signature: ________________________________________________
Relationship to student: _______________________________________ Relationship to student: ______________________________________
Daytime Phone #: ________________ Cell Phone #: __________________ Daytime Phone #: ______________ Cell Phone #: ________________
    Please write additional information on reverse side.           Please write additional information on reverse side.      
    For any questions regarding a student's attendance or the GASD           For any questions regarding a student's attendance or the GASD      
    attendance policies, please call the Attendance Office at (724) 588-2500           attendance policies, please call the Attendance Office at (724) 588-2500