Student Request to Instructor for Excused Absence In connection with the 2009 Special Olympics World Winter Games
Student Name _______________________________ Student Number ______________ Instructor Name __________________________________________________________ Course Name/Number _____________________________________________________ ___ I am volunteering for the 2009 Special Olympics World Winter Games. I understand my volunteer service may be verified with the Games Organizing Committee. ___I am taking a class/workshop in connection with the 2009 Special Olympics World Winter Games. The name and number of the class/workshop is ______________________________. ___ I am attending the Global Youth Unity Summit Rally on Monday, February 9. ___ I am participating in the Games in another way. (Internship, etc.) Please describe. _____________________________________________________________________ I request an excused absence for the following days of class. I understand it is my responsibility to obtain your agreement in order for the absence(s) to be excused. I understand I will be responsible for any material or assignments I miss during my absence(s).
Student Signature ___________________________________ Date ________________ Instructor Signature _________________________________ Date ________________