| LSC STUDENT ABSENCE AUTHORIZATION FORM |
Name: _______________________________________________ Number____________________
Date of Absence:__________________________________________________________________
Explanation:
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_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_____________________________________________________(Please attach any documentation)
Signature:________________________________________________________________________
Date:_________________________________
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Excused: yes no Comment:_______________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Signed: ________________________________________ Date: ___________________ |
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