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Excused Absence Request

First name*

Last name*

Student ID*

Absence Type*

Absence date (from)*

Absence date (to)*

Reason for absence*

Legal related (court paperwork or excuse for legal officer)

Death in family (obituary required)

Illness or injury (medical excuse required)

Medical-related appointment (medical excuse required)

Family Emergency (documentation may be require)

Other

Upload appropriate documentation

OFFICE USE ONLY

Approved

Denied

Administration signature

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