Student Absence Excuse Form

Moody Middle School: Excuse To Whom It May Concern, Please excuse _______________________________ for being absent on ___________________. He/she was absent due to (please check any/all that apply): + Not feeling well-stayed home + Doctor’s appointment (please attach excuse from doctor) + Death in the Family + Other ________________________________________________ ______________________________________________ Parent/Guardian Signature ____________________________________ Date Moody Middle School: Excuse To Whom It May Concern, Please excuse _______________________________ for being absent on ___________________. He/she was absent due to (please check any/all that apply): + Not feeling well-stayed home + Doctor’s appointment (please attach excuse from doctor) + Death in the Family + Other ________________________________________________ ______________________________________________ Parent/Guardian Signature ____________________________________ Date Moody Middle School: Excuse To Whom It May Concern, Please excuse _______________________________ for being absent on ___________________. He/she was absent due to (please check any/all that apply): + Not feeling well-stayed home + Doctor’s appointment (please attach excuse from doctor) + Death in the Family + Other ________________________________________________ ______________________________________________ Parent/Guardian Signature ____________________________________ Date