Malone Middle School
15 Francis Street, Malone, NY 12953
Phone: (518)483-7801, Fax (518) 483-9497
Principal: James C. Knight, Jr.
Assistant Principal: Dustin Relation (Dignity Act Coordinator)
Athletic Director: Eileen Kilcullen (518) 483-7807, ext. 7396
PARENTAL EXCUSE FOR ABSENCE(S)
Please fill out and submit this form within three (3) school days of the student's absence to excuse your child
due to illness only
. In cases of illness, completing this form eliminates the need for you to call. PLEASE NOTE: This form is not to be used for any other absences, such as doctor/dentist appointments, college visits, court appearances, religious holidays, vacation, etc.
If you have any questions, please contact Della Coombe Malone Middle School attendance clerk, firstname.lastname@example.org
Indicates required field
Student's Grade Level
Number Of Days To Be Excused
Date(s) Of Absence(s)
Reason For Absence(s)
Parent Phone Number
PARENT OR GUARDIAN SIGNATURE: BY ENTERING MY NAME IN THE BOX BELOW, I ATTEST THAT I AM THE PARENT/GUARDIAN OF THE ABOVE-NAMED STUDENT.