Absence Request Form

Please note – A request for an excused absence from a PERFORMANCE must be made directly to Dr. Lortz. After that discussion, you will submit this form if permitted to miss the performance.

This form can be submitted for missing class or any other rehearsal without contacting Dr. Lortz.

Please refer to the Attendance Policy in the course syllabus for the criteria of excused rehearsal and performance absences, along with the consequences of unexcused absences.

PROCEDURE:

This form must be completed and submitted within 1 week of your unanticipated absence.
To be considered for an excused absence due to illness, you must have documentation from a physician or an appropriate medical facility. Provide the date and time of the visit and attach the physician’s note.
To be considered for an anticipated absence from rehearsal, this form must be completed and submitted at least a week before the anticipated rehearsal absence.
For consideration for an excused tardy, please check “tardy” above instead of “absence.”
For any absence or tardiness, please provide any additional documentation that would help clarify your need for absence or tardiness.

Absence Request Form

Name*
First Last
Email*
Your Section*
Today's Date*
MM slash DD slash YYYY
Absence Type*
- I will be Tardy
- I will be Absent
- I will be Leaving Early
- This an ongoing absence/tardy/leave early previously discussed with Mr. Lortz.
Date of Absence
MM slash DD slash YYYY
Reason for Absence. Please be as detailed as possible, stating when and why you will need to be absent or tardy. For example, if you need to miss a basketball game, please list which game or games you need to miss and why.
CAPTCHA
Email
This field is for validation purposes and should be left unchanged.

Stevenson University Bands

Absence Request Form

Absence Request Form