A Note to School

Student: _____________________________ Date: __________________

Teacher: ___________________________ Grade: _______

Check one below:

q is late today because _____________________________________________

q will be a car rider at dismissal and will be picked up by

_____________________________________________

q will be picked up early today by ____________________

(Name)

at ____________ for ____________________________

(Time) (doctor, dentist, travel, etc.)

q is returning to school after being absent on

_____________________ due to ____________________________________

(dates) (Reason for absence(s))

q will NOT be a bus rider today because he/she is staying after school for ___________________________________________________________

(name of group or activity)

Parent/Guardian Signature:

______________________________________________

Phone Number:

______________________________________________

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

A Note to School

Student: _____________________________ Date: __________________

Teacher: ___________________________ Grade: _______

Check one below:

q is late today because _____________________________________________

q will be a car rider at dismissal and will be picked up by

_____________________________________________

q will be picked up early today by ____________________

(Name)

at ____________ for ____________________________

(Time) (doctor, dentist, travel, etc.)

q is returning to school after being absent on

_____________________ due to ____________________________________

(dates) (Reason for absence(s))

q will NOT be a bus rider today because he/she is staying after school for ___________________________________________________________

(name of group or activity)

Parent/Guardian Signature:

______________________________________________

Phone Number:

______________________________________________