Request for Pre-Arranged Absence Every student reaching the peak of success is the primary goal at McGinnis Middle School. Although learning occurs in a variety of settings, time spent directly with the teacher and collaboratively with peers is essential to student learning.

Pre-Arranged Absence Procedure 1.

Parent and student should refer to the Student Handbook for policy.

2. Pre-arranged absence form is completed by parent/guardian and submitted to the school at least 3 school days prior to scheduled absence. 3. 4.

Principal will review completed form and notify parent/guardian of approval or non-approval. Student and parent are responsible for communicating arrangements with teachers for missed work.

Student’s Name: ___________________________________________

Grade: _________________

Home-room Teacher’s Name: _____________________________________________ Date(s) of Absence: _____________________________________________________ The reason for my student’s absence(s): To Be Completed by PARENT/GUARDIAN

_____Family Trip accompanied by at least one parent/guardian _____Religious retreat, church sponsored trip, seminar or convention _____Court appearance supported by documentation from the court system _____Medical supported by documentation from a doctor’s office, hospital, clinic, etc. _____Other: (please explain) ________________________________________________________ I understand that absences will be coded in accordance with the BVSD Administrative Policy set forth in the student handbook.

Parent Signature: _______________________________________

Date: _________________

Teachers may give assignments prior to or after this absence. Students must complete all makeup work assigned by teachers.

Period 2 MMS TEACHER

To Be Completed by

Period 1 Period 3 Period 4 Period 5 Period 6 Period 7 ____ This Absence will NOT adversely affect this student’s education/grade

To Be Completed by MMS OFFICE

____ This Absence WILL adversely affect the student’s education/grade

Current # of Absences: Excused __________ Unexcused __________ Tardies _________ Final Approval: Yes __________ No ___________ Administrator Signature: ___________________________________________ Date: _______________ Comments: ____________________________________________________________________________

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