B.H.S.S. Request for Administrative Excusal Absence Excuse Form
Member Name:
Contact Info:
Signature:
Please list below the dates on which you were unable to attend a meeting or meetings: Date: Initials (Each date please):
Below, please provide us with an honest explanation so that we may evaluate your request for Administrative Excusal:
By signing this form I agree that if any of the above information is illegitimate or irresponsible, my attendance will not be excused: THIS FORM is due to the BHSS Officers NO LATER THAN Tuesday, November 17th. All late forms will be declined, unless otherwise stated. This form is subject to conditional approval, there is no guarantee you will be granted your request.
Approved: Member Signature: Officer’s Approval: