Absence Approval
Form
This form must accompany the Community Engagement Mini-Grant Application
Form 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.