2017-2018 ROCHESTER ELEMENTARY SCHOOL PRE-ARRANGED ABSENCE
THIS NOTICE WILL NEED TO BE FILLED OUT BY THE PARENT AND SIGNED BY THE TEACHER BEFORE AN ABSENCE IS TO TAKE PLACE. PLEASE REMEMBER THAT THE ROCHESTER SCHOOL DISTRICT DISAPPROVES OF EXTENDED VACATIONS AND ABSENCES FROM SCHOOL FOR LONG PERIODS OF TIME IF NOT DUE TO AN EMERGENCY. YOUR COOPERATION WITH THIS MATTER WILL GREATLY BE APPRECIATED.
STUDENT NAME:______________________________________________________ PARENT/GUARDIAN SIGNATURE:_____________________________________ DATE/S OF ABSENCE:______________________________________________ STATE REASON FOR ABSENCE:
_________________________________________________________ TEACHER SIGNATURE SEE TEACHER TO MAKE ARRANGEMENTS FOR HOMEWORK AND MISSED ASSIGNMENTS
_________________________________________________________ PRINCIPAL OR ASSISTANT PRINCIPAL SIGNATURE
Page 1 of 1. 9/03. Adams Central Community Schools. Pre-Arranged Absence Request. ACCS recognizes that in rare circumstances a student is needed at home or a family vacation can only be scheduled during. the school year. The designated administrator
