2012-13 Weekly School Absenteeism
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2012-2013 School Absenteeism Survey

 
*Only illness absentees are to be reported, not absentees due to sports trips, school activity trips, dental appointment, vacations, etc. A student is counted for each day absent. If a student is absent 3 days in a week he/she would be counted 3 times.

If you have questions please do not hesitate to contact Vickie Horan, 773-3737 or 800-592-1861.
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1. School week for which you are reporting:
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2. What is your School District?
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3. What is the name of your school?
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4. County your school is physically located:
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5. School point of contact: (Name)
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6. Phone number for Point of Contact:
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7. Number of students enrolled: (please enter a number)
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8. Number of student absent days due to illness: (please enter a number)
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9. Number of staff: (If no data enter 0)
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10. Number of staff absent days due to illness: (If no data enter 0)
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11. Number of scheduled school days this week:
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12. Was school closed any days this week?
13. If yes, why was the school closed? (i.e. snow day, in-service, vacation, illness, etc):
14. If yes, how many days was your school closed? (Please enter a number)