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Report Absences
Report an Absence
Liberty Elementary may call to verify if an absence submitted using this form is legitimate.
By law all fields on this form are mandatory!
Student Name
Student's Teacher
Parent/Guardian Name
Contact Phone Number
Contact E-mail
Teacher Name
Date(s) of Absence
Reason for Absence
Illness - Doctor's Note
Illness - No Doctor's Note
Family Emergency
Out of Town
Other - Please Explain
(Please Provide Doctor's Note if Applicable)
Notes or Explanation
Liberty Elementary School
1250 E. Liberty Hill Road • Fresno, California 93720
559-327-7100 • 559-327-7190 (FAX)