Attachment
I
REQUEST
FOR AN EXCUSED ABSENCE
Student Name: ________________________________ TxState ID______________________
Print
Name
Name of
Organization___________________________________________________________
Event______________________________________Date/Time_________________________
The above-named student will be involved
in an officially-sponsored university event, and will be unable to attend the
classes on the dates and times listed below. Please grant this student an
excused absence for the class sessions indicated.
Course Class Dates
Course Name Number Instructor Meeting Time of absence
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This request must be signed by the
advisor or director of the organization sponsoring this event.
________________________________Please
print___________________________________
Signature, Advisor/Director Full
Name, Advisor/Director
Advisor e-mail__________________________
Phone #_____________Date_______________
TO THE STUDENT:
Your absences during this university-sponsored
function do not excuse you from completing all work associated with the classes
that are missed. When you present this form to the instructor, you and your
instructor should discuss the coursework for which you will be responsible upon
your return. You are responsible for obtaining this information and completing
the assignments in a timely manner. You or your instructor should keep the
completed form to document your instructor’s approval of your request.
TO THE INSTRUCTOR:
To verify the authenticity of this
request, please go the website
where you will find a listing of all officially-sponsored university events
that have been registered. If an event is not listed, or if the form is not
signed, this request may be invalid. Please reference UPPS No. 02.06.03
to review the official university policy. Questions may be directed to Student
Involvement @ LBJSC at 512.245.3219.
________________________________Please
print___________________________________
Signature, Instructor
Full Name, Instructor