External Sites - Online Request for Absence

2013-2014 Academic Year

Today's Date: 5/ 17/ 2025

NOTE: CEC policy requires that a request for absense must be made with a minimum of four (4) weeks notice. Additionally, requested absences around holiday weeks/breaks or the first or last week/day of any rotation will most likely not be approved.

All fields are required.

Please acknowledge the statement below:

I understand this is a "request form" and not a "notice given" form :

Student Name
Student E-mail Address
Graduation Year
Site
Attending

Date(s) of Absence(s)

From:

To:

Is absence related to NBEO CLINICAL SKILLS

yes no

Reason (Max 500 characters.)

Proposed Method of Make-up (Max 500 characters.)

Webmaster:Dr.Ralph Garzia & Garima Dhawan
Last Updated: May -25- 2010