APPLICATION FOR STUDENT LEAVE

Application by parents for Student Leave from school for a trip during the school year

Student name _________________________ Grade __________________

Address ______________________________ Phone __________________

Destination ____________________________________________________

Date Leaving _________________________Date Returning to School _______________

State clearly and concisely the nature of this trip. Give reasons why the leave must be taken on school time. ________________________________________________________________________

________________________________________________________________________

STATEMENT OF STUDENT AND PARENT

We understand that absence from school for the reasons listed above is not provided for under the school attendance laws of the state of Ohio ; but that by completing this form and fulfilling the requirements the student will be permitted to make up work missed and will not be considered truant.

We further understand that for the best interests of the students all school work missed during such absence must be made up; that as much of this make-up work as possible is to be completed prior to leaving on the trip and that the remainder of the make-up work is to be completed upon return to school within a period of time equal to one-half the number of days missed while on the trip. Example: Absent ten (10) days, student has five (5) days to make up work.

In the event of this application is granted, we promise our wholehearted cooperation in fulfilling the requirements listed on the reverse side of this sheet.

Date _________________ _________________________________

Student’s Signature

______________________ _________________________________

Principal’s signature Parent’s Signature

REQUIREMENTS FOR MAKE-UP WORK

Teachers: The student named on the reverse side of this sheet has been granted permission to be absent from school under the terms stated in the application. Each teacher will list the specific requirements for make-up work in the space provided. Credit will be given in the teacher’s records. It is understood that while this is a cooperative agreement the responsibility for meeting requirements is that of the student. Teachers will not be expected to assume an unreasonable burden in making this opportunity for the students.

COURSE__________________________ Teacher’s Signature___________________________________

Requirements___________________________________________________________________________

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