Students fill this document out when they did not complete their homework. As the teacher collects assignments, the student submits this document in place of the assignment with an explanation of why it is not done and with the understanding that it is due the following school day for late credit.
It can be printed on a different color paper so it stands out easily for the teacher.
This makes it easy for the teacher to stay organized when collecting assignments, so they do not have to call anyone up or leave a blank score or check in mark until they speak with that student. The teacher is able to make note of it easily, without putting any student on the spot or wasting time finding out the reason, and move on with the lessons and activities of the day.
It also gives the teacher an idea of what is going on at home, based on what the student writes as their excuse and if needed, they can speak with them when it is appropriate, without other students hearing the discussion (like at lunch or after class).
Finally, the teacher gathers these alerts, places them in the student files, and keeps them as documentation and evidence to show parents (or other staff working with this student i.e. counselor, etc...), as needed (scan into emails, show at conferences, bring to behavior or IEP meetings, etc...).