Kirkland Ranch K-8 Reporting of an Absence

Submission of this form does not guarantee the absence will be an approved excused absence. Please consult the district's Student Code of Conduct for acceptable excused absence reasons (https://www.pasco.k12.fl.us/ssps/page/conduct)

If an absence is approved as an excused absence, please allow at least 24 hours for this to reflect in myStudent. Any student with an approved excused absence, has the right to make up any and all assignments assigned on the day(s) of absence at full credit. The student is responsible for asking the teacher(s) for assignments an make-up tests within two (2) class meetings with the teacher. The teacher(s) shall specify a reasonable period of time for completion of make-up work. In no case shall the time be less than one full calendar for each day missed. Work due to be turned in on the day of the excused absence will be turned in upon return with the potential to earn full credit. The principal or designee shall have the authority to modify these conditions with a confirmed hardship. (Source: Portion from District School Board of Pasco County Secondary Student Code of Conduct.)

Student Name Student Name First Last
Student Number
Grade Level
Date Absence Started: Date Absence Started: / MM / DD YYYY
Date Absence Ended: Date Absence Ended: / MM / DD YYYY
Parent/Guardian's Name Parent/Guardian's Name First Last
Parent/Guardian's Phone Parent/Guardian's Phone - ### - ### ####
Parent/Guardian's Email
Reason for Absence

Reason for Absence Illness of student (if selected, you have the option to state diagnosis in the brief description section below) Major illness in the immediate family of student Death in the immediate family of student Religious holiday of student's faith Other Other
Upload a File (notes from doctor, urgent care, ER...)

Attach Files
Brief Description (voluntary reporting of diagnosis/symptoms)
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Today's Date Today's Date / MM / DD YYYY
Spam Protection. Please answer this simple question:
8 + 1 = ?