Excused Absence Request Form

Excused Absence Request Form
Student ID
Name

First NameLast Name
Mobile Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
BRTC Email
example@example.com
Please list the first and last names of your current instructors:
Please select the reason for your absence:
Dates Absent from Class(es): Enter Range
Excused absences may be honored retroactively with appropriate documentation. Retroactive excused absences will be no more than 10 days after the date of the absence. No absences will be honored after the end of the term. Exceptions to this policy are limited and made on a case-by-case basis.
Acceptable Documentation

Excused absence dates, or range of dates, must be listed on documentation. Documentation must be signed by a licensed/qualified professional. Obituaries do not require a signature.
Unacceptable Documentation

Handwritten notes requesting an excused absence will not be accepted. Documentation that cannot be verified by a licensed/qualified professional may be denied. Transportation issues or internet connectivity issues do not qualify for an excused absence.
Upload Your Documentation: Documentation must be clear, easy to read, and uploaded vertically. Our office may not be able to excuse absences if the above directions are not followed.

Cancelof
I understand the following:
Signature
Should be Empty:

Acceptable Documentation