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Forms
Over-the-Counter Medication Form
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Student Insurance by 1st Agency
Rural Virtual Academy
Rural Virtual Academy
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RVA Preview Course Catalog
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Odysseyware Course Options
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National Center For Homeless Education
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Report Student Absence
Report Student Absence
Forms
This form requires Javascript to be enabled for submission and authorization.
*
Required
Student Name
*
required
First Name
Last Name
My child attends:
*
required
Park Falls Elementary School
Glidden Elementary School
Chequamegon Middle School
Chequamegon High School
Date: Example - 3/10/2020 or 12/20-12/22/2020 for multiple days
*
required
My child will be gone:
*
required
Part of the day
All day
Time of Dismissal: Example (8:00 am - 3:30 pm or 1:30 pm)
*
required
Reason for Absence:
*
required
Please see the student/parent handbook for more specific information about attendance rules, policie
Medical or Legal Appointment - verified with doctor's excuse
College Visit - up to 3 per year, verified with counselor
Parental Excused Absence - up to 10 per year
Other - discuss with principal
Please see the student/parent handbook for more specific information about attendance rules, policie
If illness, please check all that apply:
Congestion/Runny nose
Cough
Difficulty Breathing/Shortness of Breath
Fever/Chills
Headache
Muscle/Body Aches
Nausea/Vomiting/Diarrhea
Rash
Sore Throat
Phone number:
*
required
Signature
*
required
First Name
Last Name
Email Address
*
required
Please enter your email address. You will be emailed a copy of this signed form at this address.
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