Please note:

 This form must be submitted one week before the scheduled exam

 

 

APPLICATION TO BE EXCUSED FROM EXAM

 

 

 

 

I am making this request to be excused from  exam # ____, scheduled for ___________________.

 

The reason I need to be excused from  exam # ____ is:

 

 

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Name, print

 

 

 

 

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Name, signature

 

 

 

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Date