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Request for an Excused Absence or Excused Late

 

 

 

1. Your Name: _____________________

 

2. Course Title: ____________________

 

3. Scheduled Days and Hour of the Course: ________________

 

4. Today’s Date: _______________________

(Must be submitted no later than 1 week after the absence or late.)

 

5. Excused Absence for the Date of ___________  or  Excused Late for the Date of __________

 

Reason:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Type of Documentation (attach):

 

 

 

 

 

______________________________________________________________________________

 

This section will be returned to you if your request is not approved.

 

Excused absence or late for the date of _______________ was not approved.

Reason: