Kent ISD
Truancy Forms Submission

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School Attendance Affidavit and Referral FormTM


School Information

** Date Parent / Guardian was notified by a local school administrator by letter or telephone call.
   Michigan Law requires this notification before referral to the Kent ISD Office of Truancy and School Attendance.

Student Information
Male Female
Yes  No
Yes  No

Yes  No
Parent / Legal Guardian 1
Mr.  Mrs.  Ms. 
Yes  No
Parent / Legal Guardian 2
Yes  No
Mr.  Mrs.  Ms. 
Yes  No
Yes  No
Referral Information
1st  2nd  3rd  4th  5th  6th  7th  8th  9th 
Absences
days
days
days
days Counted vs. Uncounted Absences
days
days
This includes all absences (excused & unexcused), late arrivals, early dismissals, and missed classes. It does NOT include Suspensions, Expulsions, and “Uncounted Absences.”

By checking this box, under penalties of perjury, I declare that I have examined this affidavit and any accompanying statements or attachments, and to the best of my knowledge and belief, they are true, correct and complete.

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