Student Absence Request Form

Please note: According to KHDA regulations, student attendance

is rated the following:
2016-2017 Academic Year
UNSATISFACTORY
Less than 92%

ACCEPTABLE

GOOD

OUTSTANDING

92 95 %

96 97%

98 -100%

14 days or more
absent

9 14 days
absent

5 8 days
absent

4 days or less
absent

Student Name
Grade
Teacher / Homeroom
Dates of Absence

From:

Return Date:

Name of Parent /
Guardian
Reason for Absence
(Please give a full and
detailed reason for
absence.)

Signature of parent
Date
Date
Teachers Signature
Date
Principals Signature

If a student misses more than 10 days in a semester or 20 days in

a year, the school reserves the right to retain a student if the
absences have affected their progress.