Kent ISD
Truancy Forms Submission

Create

Attendance Affidavit and Referral FormTM

NOTE: We are no longer processing 2020/21 referrals as of May 28, 2021. If you have a matter that requires a timely response please contact us via phone (616-365-2298) or email at truancy@kentisd.org.

We will begin processing referrals for the 2021/22 school year starting August 16, 2021.


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
Please explain "Other" in comments section
Yes  No

Yes  No
Parent / Legal Guardian 1
Mr.  Mrs.  Ms. 
Yes  No 1

1If no, it is the school's responsibility to translate to the family.
Parent / Legal Guardian 2
Yes  No
Mr.  Mrs.  Ms. 
Yes  No
Yes  No 2

2If no, it is the school's responsibility to translate to the family.
Referral Information
1st  2nd  3rd  4th  5th  6th  7th  8th  9th 

(The number of times tardy to 1st hour only)
Absences
days
(Number of days in the school year minus UNCOUNTED absences and DAYS SUSPENDED.)
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.