ABSENCE FROM CAMPUS & CLASS COVERAGE FORM 

FACULTY NAME:_______________________________TODAY’S DATE:_____________

Date(s) Absent (NOT ON CAMPUS):__________________________________________________________

Religious Holiday〘 〙Health Problem〘 〙Conference^✲〘 〙Other^✤〘 〙

✲   Please list name of Conference:____________________________________________________
(check all that apply)  Presentation  ❒   Poster  ❒   Chair Session  ❒   Attending Only  ❒

✤   If other please specify:_____________________________________________________________

Please indicate below the coverage that has been arranged:

If coverage will be in the form of a make-up class by the Instructor, please specify: