Pike Christian Academy
Vacation Information Form
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Student’s Name
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Teacher
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Vacation Dates
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Destination
List any educational opportunities this student will have while out of school:
PARENTS
Please submit this form to the main office at least two weeks in advance of the dates. This will
give our teachers adequate time to prepare the student’s work for the time missed.
PLEASE NOTE: all work is due the day the student returns from vacation.
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Parent Signature
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