HOMEWORK FORM
(PRE-PLANNED ABSENCE)
Student Name: _____________________________ Grade: _____
Home Ph. # ________________
Dates of Absence: From ________________________________ To__________________________
Reason for Absence: ________________________________________________________________
Teacher Communication of Extended Absence:
Period
Class
Assignment
Teacher Signature
1
2
3
4
5
6
7
This form is designed to assist students with making the necessary arrangements to complete academic
assignments they will miss during a foreseeable absence. It does not excuse their absence. All absences
will be coded by the attendance office in accordance with board policy 803.00. If you have any questions
regarding the status of an upcoming absence, please contact the Attendance Office. Thank you.
Kristen Dow, Attendance Office (608) 877-5608
Vicki McClurg, Administrative Assistant to the Associate Principals (608) 877-5604