Online Class Absence Form
(ALL FIELDS MUST BE COMPLETED)

The specific details for the absence will not be shared beyond the Dean of Students Office. The reasons for the absence that will be sent to the instructors will be categorized in one of the following: Authorized University Activity, Illness, Injury, Emergency or Work. (see: UW-Eau Claire Absence Policy)

The Dean of Students Office will notify instructors when the student is absent for fewer than three days if the reason for the absence is family or personal emergency or a death in the family. If the student is absent fewer than three days for another reason, it is his/her responsibility to contact his/her instructors personally, or leave a message with the department secretary.

 
Student Name :
I.D.# (OR S.S.#)
Student's Phone Number
E-mail Address
Student Local or Campus Address
Submitted By
Submitter's Phone Number
Relationship to Student

Reason For Absence:

(Please be Specific)


 

First Day of Absence
Thru this Date
(An ending date is required. It may be extended by notifying the Dean of Students Office.)

 

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