OLMC

Student FIRST Names (Separated by commas): *

Student LAST Names: *

Student Homerooms: *

KA - Mrs. Vullo

KB- Miss Makar

1A - Mrs. Swan

1B - Mrs. Lee

2A- Mrs. Lamb

2B - Mrs. Arnold

3A - Mrs. Hartley

3B - Mrs. Abbott

4A - Mrs. Lengemann

4B - Mrs. Mills

5A - Mrs. Pichardo

5B - Mr. Pezzuto

6A - Mrs. Hyde

6B - Mrs. Evans

7A - Mrs. Knox

7B - Mr. Sanders

8A - Mr. Abbott

8B - Mrs. Gjerstad

Absence, Late Arrival, or Early Check Out *

Full Day Absence

Late Arrival

Early Check Out

For an Early Check Out, what time will you pick up the children?

Reason *

Date of Absence: *

End Date of Absences (if student will be out more than one day):

If you would you like missed work sent home with another child what is the child's name and homeroom?

Your Name: *

Your Email: *

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