TEACHER COMMUNICATION FORM
To:________________________________________________________________
Parent Name/Signature:_______________________________________________
Date:_______________________________________________________________
Student Name:_______________________________________________________
where appropriate
______ Please excuse my child from school on the following dates
___________________________. He/She was absent due
to___________________________________________________
______Late due to____________________________________________________
______Leaving early: Time Leaving______________________________________
Reason Leaving_________________________________________________
Person Leaving With_____________________________________________
______Other________________________________________________________
____________________________________________________________
____________________________________________________________