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2. Instructions

   Complete all required fields. Only parent/legal guardian can authorize an absence or tardy. IP addresses are linked to this form to verify the validity of the absence and/or tardy.

   Please allow 7-10 business days (not including holidays) for the student's attendance to reflect on Focus.

4. Student First Name*
5. Last Name*
7. Student Grade*
   -- Select One --678
9. Parent First Name*
10. Last Name*
12. Parent Email*
13. Parent Phone Number*
15. Date of Absence*
    Date of Absence
16. Time Signed Out/In
    Time Signed Out/In
    If you are signing your child in tardy, please put the time they signed in to classes. if you are signing them out early, please put the time they will be leaving their classes.
17. Student Was (Choose ONE)*

    1. Tardy to School
    2. Absent to School
    3. Signed Out Early
19. Reason for Tardy, Early Sign Out, or Absence*
    -- Select One --Illness of StudentIllness of Family MemberDeath in the FamilyReligious Holiday of the Student's Own FaithRequired Court AppearanceSpecial Event (please complete form and email)Scheduled Medical Appointment (you must submit the medical form from the doctor)Technical Issues (no internet, Zoom issue, computer issue, etc.)Username/Password issueOther (Please Explain)
21. Student Request for Absence Form
    Student Request for Absence Form

    If option "Special Event" was chosen, please fill out the Student Request for Absence Form directly above, and then email the Attendance Clerk at rlopez@pinescharter.net. with the form attached.

25. Comment
    Please put as much information as you can in this field to help expedite your request.
27. Medical/Hospital Note Upload
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit Submit and Print

* indicates a required field