Attendance Form

Submit an absence or late arrival online

Please be specific about the reason why your child will not be attending school today. In the "Reason for Absence/Late Arrival" blank space on the form below, indicate whether your child has any of the following symptoms:

Feeling feverish or chills
Fever greater than or equal to 100.4 F
Headache (not due to another health condition, hunger, menstrual cramps stress, or injury)
A new cough (not due to another health condition)
Shortness of breath or breathing difficulties (not due to diagnosed respiratory condition or if different than normal pattern of chronic condition)
A new sore throat (not due to another health condition)
Congestion or runny nose (not related to allergies or health condition)
Fatigue (more tired than normal or sudden onset)
New muscle pain (not due to another health condition or that may have been caused by a specific activity such as physical exercise)
New loss of taste, smell, or appetite
Abdominal pain (not due to hunger, constipation, injury, or stress)
Nausea, vomiting or diarrhea

This attendance form is to be submitted by the parent/legal guardian only.

Date of Absence/Late Arrival

Consecutive Day Absences?

Please check this box if you wish to report consecutive day absences.

Consecutive Absence Dates

Please list the specific consecutive dates of the absence.

Student's First Name

Student's Last Name

Grade

Teacher Name

Reason for Absence/Late Arrival

Parent/Guardian Contact Information

Parent/Guardian First Name

Parent/Guardian Last Name

Phone Number

Alternative Phone Number

Parent/Guardian Email Address

By submitting this form, you are confirming that you are the parent or legal guardian of the student

Additional contact Information (if needed):

703-502-3519 (Attendance Line)

703-502-3500 (Main Office - hours 8 a.m to 4:30 p.m.)

CentrevilleElem.Attendance@fcps.edu (Send an attendance email)

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FCPS

Attendance Form

Submit an absence or late arrival online

Parent/Guardian Contact Information

Additional contact Information (if needed):