In order to better serve you, please fill out this form for any absences or requests for withdrawal. Thank you!

Parent/Guardian Name

First Name

Last Name

Phone

(###)

###

####

Student Name

First Name

Last Name

School Name

Absence/Withdrawal

I am reporting an Absence

I am requesting my child be withdrawn from the program

Absence Reason

Withdrawal Reason

If you are withdrawing your student, you may be contacted by an administrator for more information. If withdrawing for academics, please contact academics@jnsarts.org. We offer tutoring and homework help during the afterschool program and are ready and willing to help your student succeed!

Notes

Please add any additional and pertinent information. Please email any documentation to ops@jessyenormanschool.org

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Thank you to our partners

Jessye norman School of the Arts