JEA-R1.2 Planned Absence Request

File: JEA-R1
South Portland School District
Planned Absence Request
Grades 6-12

To be completed and returned to school office at least one week prior to planned absence.
Name of Student________________________________________ Date ____________________
Grade ______________________ Dates of Planned Absence ___________________________
Reason for Planned Absence _____________________________________________________________
_____________________________________________________________________________________

Board of Education Policy: excerpt from Policy JEA - Compulsory Attendance
Excusable Absence: A person’s absence is excused when the absence is for the following reason:
E. A planned absence for a personal or educational purpose which has been approved.

All assignments are to be made up within five school days of return. Teachers are not required or expected to prepare assignments prior to the absence for personal or educational purpose.

Prolonged absence will jeopardize typical progress.

The following course information is to be completed by all teachers prior to receiving student, parent, and Principal signatures:

Student Progress To-Date
Course (Passing/In Danger of Failing/Failing)
____________________________ ____________________ _____________________________________
Teacher Signature/Date
____________________________ ____________________ _____________________________________
Teacher Signature/Date
____________________________ ____________________ _____________________________________
Teacher Signature/Date
____________________________ ____________________ _____________________________________
Teacher Signature/Date
____________________________ ____________________ _____________________________________
Teacher Signature/Date
____________________________ ____________________ _____________________________________
Teacher Signature/Date

*****************************************************************************************

My signature below indicates that I’ve read, understand and agree to abide by this form:

_____________________________________________ _____________________
Parent/Guardian Signature Date
_____________________________________________ _____________________
Student Signature Date
____________________________________________ ____________________
Principal’s Signature Date

File: JEA-R2
South Portland School District
Planned Absence Request
Grades K-5

To be completed and returned to school office at least one week prior to planned absence.
Name of Student________________________________________ Date ____________________
Grade ______________________ Dates of Planned Absence ___________________________
Reason for Planned Absence _____________________________________________________________
_____________________________________________________________________________________

Board of Education Policy: excerpt from Policy JEA - Compulsory Attendance
Excusable Absence: A person’s absence is excused when the absence is for the following reason:
E. A planned absence for a personal or educational purpose which has been approved.

All assignments are to be made up within five school days of return. Teachers are not required or expected to prepare assignments prior to the absence for personal or educational purpose.

Prolonged absence will jeopardize typical progress.

The following course information is to be completed by all teachers prior to receiving student, parent, and Principal signatures:

Student Progress To-Date
Grade / Class * Demonstrating typical progress and/or Meeting IEP goals
* Not making typical progress and/or Not Meeting IEP Goals
____________________________ ___________ _______________________________________________
Teacher Signature/Date
____________________________ ___________ _______________________________________________
Teacher Signature/Date
____________________________ ___________ _______________________________________________
Teacher Signature/Date
____________________________ ___________ _______________________________________________
Teacher Signature/Date
____________________________ ___________ _______________________________________________
Teacher Signature/Date
*****************************************************************************************
My signature below indicates that I’ve read, understand and agree to abide by this form:

_____________________________________________ _____________________
Parent/Guardian Signature Date
_____________________________________________ _____________________
Student Signature Date
____________________________________________ ____________________
Principal’s Signature Date

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