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Excused Absence Request Form – 1st & 2nd Year
Home
Private: Academic Affairs
Excused Absence Request Form – 1st & 2nd Year
Excused Absence Request Form – 1st & 2nd Year
Tony Varin
2019-04-22T12:55:07-06:00
This form is only for 1st and 2nd year students.
If you are a 3rd or 4th year student, please use the form:
Here.
Thank you.
Student Information
Student's Name
*
Date of Request
*
MM slash DD slash YYYY
Student Class
*
Please make sure you select the correct class.
Class of 2023
Class of 2024
Class of 2025
Email
*
Enter Email
Confirm Email
Absence Details
Date From:
*
MM slash DD slash YYYY
Date To:
*
MM slash DD slash YYYY
Time
Set Time
All Day
Time from:
:
Hours
Minutes
AM
PM
Time to:
:
Hours
Minutes
AM
PM
Courses and Events Being Missed
*
Students are required to list courses or events that will be missed during absence. Please list in detail the affected course or event, e.g., exam, lab, quiz, etc., and instructor or event contact.
Course or Event
Time of Course or Event
Instructor or Event Contact
Circumstances of Absence:
*
Supporting Documentation
(i.e. Doctor's note, student organization conference registration, etc).
Drop files here or
Select files
Max. file size: 20 MB.
Signature
Date
MM slash DD slash YYYY
X
X
