Excused Absence Request Form – 1st & 2nd Year Student InformationStudent's Name* Date of Request* MM slash DD slash YYYY Student Class*Please make sure you select the correct class.Class of 2023Class of 2024Class of 2025Class of 2026Email* Enter Email Confirm Email Absence DetailsDate From:* MM slash DD slash YYYY Date To:* MM slash DD slash YYYY Time Set Time All Day Time from: : Hours Minutes AM PM AM/PM Time to: : Hours Minutes AM PM 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 EventTime of Course or EventInstructor 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: 8 MB. SignatureDate MM slash DD slash YYYY Δ