Request for excuse
Please print out the following form, fill it in, and give it to Prof. Neri.
Requests for excuses will not be processed unless you fill out the entire form and
attach written documentation for your excuse.
Name:
Phone number:
Email address:
Social Security number/student ID:
Your TA's name and section number:
Assignment for which you are requesting an excuse:
Date assignment due:
Reason for this request:
Person I can contact to verify your excuse (please include a phone number):
Your signature indicating that everything above is actually true and acknowledging that
false excuses will be treated as cheating cases: