ERHS Student Attendance Appeal Form

The purpose of completing this form is to appeal an absence or absences that you may have had over the
duration of the semester, for extenuating circumstances. These may include, but are not limited to: medical,
legal or social services. Upon completion of this form, it is to be turned in to Mr. Standerfer. He will then
review the appeal with Principal Travis. The student may be required to meet with Mr. Travis and Mr.
Standerfer to determine if the circumstances are truly extenuating and eligible to be waived.
*Please note that some appeals may be conditionally granted and require additional action on the part of the
student to earn credit.

Student:
1. Total absences accumulated, for this semester, at this time:

1st hour _______

2nd hour_______
3rd hour_______

4th Hour______
5th Hour______
6th Hour______

2. Dates of absence(s) you wish to be waived ___________________________________________

3. Reasons you believe the absence(s) are extenuating ______________________________

_____________________________________________________________________
_____________________________________________________________________
____________________________________________________________________
_____________________________________________________________________
4. Do you have any documentation to support your request?
If so, please attach.

Yes

___________________________
Student Signature

________________
Date

___________________________
Parent Signature

________________
Date

Request approved

____________________
Signature

________________
Date

____________________
Signature

________________
Date

No

Request denied

Note: All appeals must be submitted to Mr. Standerfer as soon as possible each semester and no later than 7
calendar days (1 week) before the last day of each semester.