Lakeside Lutheran High School
Excuse Form Please excuse _______________________________________ (name) on ____________________ (date)
CHECK ONE
CIRCLE ONE
___ Tardiness ___ Absence ___ Appointment
1. 2. 3. 4. 5. 6.
Illness Vacation Doctor Dentist Funeral Other: ____________________________
STATE SPECIFIC REASON:
____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________
______________________
________________________________________________________________
DATE
PARENT SIGNATURE
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - cut & save - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - -- - - - - - - - - - -- - - - - - - - - -
Lakeside Lutheran High School
Excuse Form Please excuse _______________________________________ (name) on ____________________ (date)
CHECK ONE
CIRCLE ONE
___ Tardiness ___ Absence ___ Appointment
1. 2. 3. 4. 5. 6.
Illness Vacation Doctor Dentist Funeral Other: ____________________________
STATE SPECIFIC REASON:
____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________
______________________ DATE
________________________________________________________________ PARENT SIGNATURE