THIS FORM FOR DEPARTMENTAL USE ONLY

Notice of Absence from Class/Class Cancellation *

Absence from class for any reason should be reported on this form. Absence from class for reasons other than illness or emergency requires prior permission from the Department Chair. Informal voluntary substitution by a University colleague is permissible, but requires prior permission from the Chair. Classes should be canceled only in exceptional circumstances, and normally appropriate alternative assignments/activities should be provided.

Please complete the following information and submit this form to the Department Chair as early as possible before the anticipated absence from class, if absence was due to illness or emergency (or as soon thereafter as possible).

Name   ______________________________________________________________

Class ______________________________________________________________

Date(s) of Absence ___________________________________________________

Reason for Absence

Arrangement for Class(es) Missed (Name of Substitute OR Alternative Assignments/Activities, if applicable):

Signature ________________________________________

Date ___________________________________________ 

		Received by Chair (Signature) _________________________________

		Date ___________________________________

* This form is not required for use of personal holiday that is taken upon mutual agreement of the faculty member and appropriate administrator. In cases of absence involving University-related travel, this form is not a substitute for the standard travel authorization form.

As of July, 2013