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Absence Verification Form

seal seal

Use the following form to clear your child's absence(s). If you have a doctor's note please bring it to the main office or upload a copy below. If you have any questions you may call the main office at (818) 347-2681.

Student's First and Last Name*

Answer Required

Student's Date of Birth*

Answer Required

Room Number:

Answer Required

Date of Absence*

Answer Required

Reason for Absence:*

Answer Required

Illness

Doctor/Medical Appointment

Funeral

Other

Please explain reason for absence:

Answer Required

If you have a doctor/dental note, please provide a copy here.

Answer Required

Choose a file or drag it here.

Parent / Guardian's First and Last Name*

Answer Required

Parent Signature*

Signature Required

Confirmation Email

Confirmation Email *

Email Required