Request for Absence from Student Teaching
Approval for a planned absence
, including early dismissal and late arrival
, must be made 48 hours
prior to the absence with approval from both the Mentor Teacher and University Supervisor. As
stated in the Student Teaching Handbook under the section on Professional Conduct, absences
are reserved for serious illness or death in the immediate family. Any other absences may
negatively impact your evaluation and grades. In the event of an unplanned absence, this form is
to be submitted as soon as possible to your Mentor Teacher and University Supervisor following
an absence. Once signed, please submit to
Student teacher:
Today’s date:
Dates and times of leave:
Reasons for leave (Check those that apply). Please use the box at the bottom of the page for
additional comments/concerns.
Sick leave
Emergency-Please explain using the box at the bottom of the page
Approved professional development-Please explain using the box at the bottom of the page
er-Please explain using the box at the bottom of the page
Absences will not be approved unless all signatures are included. Absences will require students
to make up days. A copy of this form will be submitted to and placed
on file.
dent Teacher
Signed: ______________________________________________________________________
iversity Supervisor
Please use this space for for all explanations: