Editing previous response:

Please fix the highlighted areas below before submitting.

Family Vacation Request Form

To request an excused absence for a family vacation, please complete this form and submit it at least two (2) weeks in advance of the planned absence. Approval is required for the absence to be excused. Please be aware that approval is not guaranteed.

Please complete the form below. Required fields marked with an asterisk *

Student First Name*

Answer Required

Student Last Name*

Answer Required

Grade*

Answer Required

Teacher Name*

Answer Required

Parent/Guardian First Name*

Answer Required

Parent/Guardian Last Name*

Answer Required

Email*

Answer Required

Phone Number*

Number Required

Dates of Absence

Starting Date*

Answer Required

Ending Date*

Answer Required

Total number of school days missed (numbers only)*

Answer Required

Vacation Details

Destination*

Answer Required

Briefly describe the reason for your planned trip*

Answer Required

Please outline how you plan to facilitate your child completing any missed assignments during or after the vacation*

Answer Required

Parent/Guardian Acknowledgement

I understand that approval of this request is required for the absence to be excused. I also acknowledge that it is my responsibility to ensure that my child completes all assignments and classwork missed during this time. I have coordinated with my child’s teacher(s) regarding the work to be completed before, during, or after our vacation.

Parent/Guardian E-Signature*

Signature Required

Confirmation Email

Confirmation Email *

Email Required