Absence Approval Form This form must accompany Community Engagement grant application forms if participation in the relevant program or event will result in absence from any scheduled class. Please submit only one Absence Approval form per course. I. CLASS CONFLICT INFORMATION: Student: Course: Professor: Number of Classes Missed: Proposed Absence Date(s): Reason for Absence: Brief Description / Reason for Attending: For your professor’s benefit, briefly describe the program or event listed above and explain your personal and/or academic reasons for attending the event II. (Write program or event name here) FACULTY AUTHORIZATION: I have read the above-listed “Class Conflict Information” and I authorize this student to be absent from my class on the date(s) indicated. Professor Signature: _____________________________________ Date: __________________________________________________ NOTE TO FACULTY: If you would like additional information about the above event or would like to discuss any reservation you may have about the proposed absence, please feel free to contact Ashley Laux at 802-443-3099 or send an email to alaux@middlebury.edu.