LHS Absence Report Form

	Please complete the following form to report an absence for your LHS student.

	* Required information

	Today's Date:*
	mm/dd/yyyy

	STUDENT INFORMATION

	Student's last name:*

	Student's first name:*

	Student ID #:*

	Grade level:*
	--Please Select--9th10th11th12th

	Date of Absence:*
	mm/dd/yyyy

	Detailed reason for absence:*

	PARENT INFORMATION

	Parent's last name:*

	Parent's first name:*

	Daytime phone number:*

	Select "DONE" to submit your request.