Class Coverage Information Sheet
Department _____________________________________
This form should be completed each time a faculty member will miss or has missed
her/his class(es). The form should be submitted at least one week in advance of an
absence with the exceptions of sick leave and funeral leave when it should be submitted
on a timely basis. A copy should accompany all requests for approval of travel.
Name: _____________________________________
Date(s): Starting Date: ______________________ Ending Date: ______________________
Please list which classes will be missed and explain what plans you have made for
course coverage during your absence. (attach extra pages if necessary.)
Class
Time of Meeting
Coverage Plans
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___________________
______________________________________________
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___________________
______________________________________________
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___________________
______________________________________________
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___________________
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___________________
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Reason for missing class(es):
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Professional
Personal
(attach extra pages if necessary)
Signed: _________________________________________________ Date: __________________
Chair: _________________________________________________ Date: __________________