CHS TARDY FORM

Students bring this form to the front office upon arrival to receive a pass to class.

_________________________________________, _______, ___________________________

(print student name AND student number)

(grade) (student birthday)

was late to school on ______________, at ___________________.

(date) (time)

_______________________________________

(parent/guardian name – please print)

_______________________________________

(parent/guardian signature)

______________________________________________

(parent phone number)

____________________________

(today’s date)

Illness (self, immediate family)

Doctor/Dentist appointment

Academic event

Court appearance

Check one:

Important: It counts as a day when a student misses 3 or more periods. After fifteen (15) days of

absence, whether excused or unexcused, a student will be required to turn in a doctor's note for

every subsequent absence, tardy and early dismissal to be considered excused.