CCA Science - Absence Notification Form A student with a personal absence (i.e. family vacation, etc.) or field trip will not be allowed to make up any of the work missed, unless that student notifies the instructor at least 5 days in advance of the absence using this form. Failure to notify the instructor in the time frame discussed will result in zeros for the assignments during the time of the absence. The purpose of this notification form is to allow the instructor to organize and schedule make-up work when a student has a planned absence. This does not include family emergencies or unplanned illnesses Name: _________________________________________ (Last Name)

__Per: __ Date Submitted: ______

(First Name)

(mm/dd/yyyy)

Reason for Absence (Check one): Family Vacation Field Trip (

) (Instructors Name)

Personal Reasons (Confidential) Date(s) of Planned Absence: I understand that I am responsible for the material I miss in class. I will check the website and complete all work that can be done at home. My instructor is not responsible for providing notes on material covered in class or reminding me to turn in my assignments. It is my responsibility to go to the website or out another student to gather the notes from class and to make sure all assignments are turned in. I will schedule other make-up work with the instructor prior to the absence. Tests must be made up prior to any absence (Student Signature)

(Date)

(Parent Signature)

(Date)

(Do not write below this line. For the Instructor’s use only)

Form Received:

All work will be turned in on: (Date)

(Date)

Special Notes:

All Work Turned in: ________