LCA Attendance Incident Form

Direction: Please complete all of the following items and click submit form in order to send your information to the attendance secretary. A follow-up phone call may be necessary to verify your report.

Today's Date:

Date or Dates of Attendance Incident if not today:

Student's Name:

Grade: LCAOLK3K4K51st2nd3rd4th5th6th7th8th9th10th11th12th Homeroom Teacher:Pastor CMrs. RudisillMrs. StitelyMrs. LairdMrs. FergusonMrs. HillMr. RiddleMiss CoopMrs. CrabbsMrs. CornwellMrs. Zumbrum

Type of Absence:
LCAOL Check InIllnessMedical AppointmentFamily EmergencyTransportation ProblemInclement WeatherDeath in Immediate FamilyPrearranged Absence Request I am requesting Homework (Grades 4 and below only) :

Explanation of absence (required):

Parent's Name: 
Family #:

Notes:

• Please read the School Attendance Policy for details click here.
• Family number will be required in order to avoid a confirmation call. Ask the office for this number.
• Absences for illness of 5 days or more will require a doctors note.
• All absences must be explained to assist in determining whether the absence is excused.
• Prearranged absences, 1-2 days of a personal nature, 3-5 days for travel/vacation, will be considered if the request is submitted one week or more prior to the absence
• Homework may be requested for prearranged absences and long term absences. Check box above.